[Evaluation of serum glutamic dehydrogenase activity in the diagnosis and treatment of hepatocellular carcinoma and liver metastasis].
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Most Hepatocellular Carcinomas (HCCs) are diagnosed at an advanced stage. However, HCC early diagnosis is complicated by the coexistence of inflammation and cirrhosis. The unsatisfactory sensitivity and specificity of Alpha-fetoprotien (AFP) for screening of early-stage HCC paved the way for new novel biomarkers to complement AFP such as AFP-L3. The aim of this study was the Evaluation of alpha fetoprotein-L3 (AFP-L3) as earlier marker in diagnosis of hepatocellular carcinoma in Egyptian patients. This study was conducted on 80 patients categorized into 2 groups; group 2 (40 patients with chronic active hepatitis) and group 3 (40 patients with HCC). HCC diagnosis was done by clinical, triphasic CT and positive US for focal lesion, in addition to 20 healthy individuals as controls (group 1).The median range of AFP and AFP-L3 were highly statistically significant difference between HCC group and other groups [p < 0.001]. In this study ALT, AST, Total & direct bilirubin and albumin results showed highly significant differences between HCC group and other groups. Serum AFP-L3 shows sensitivity 100%, specificity 100%, positive predictive value 100% and negative predictive value 100% with AUC = 1 in HCC cases.Serum AFP-L3 may serve as a diagnostic biomarker for the detection of early stage of HCC and show higher sensitivity than AFP.
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Lung metastasis, the most frequent metastatic pattern in hepatocellular carcinoma, is an important contributor to poor prognosis. However, the mechanisms responsible for lung metastasis in hepatocellular carcinoma remain unknown. Aiming to explore these mechanisms, weighted gene coexpression network analysis (WGCNA) was firstly used to find hub genes related to lung metastasis. Then, we obtained 67 genes related to lung metastasis in hepatocellular carcinoma which were mainly related to ribosomal pathways and functions, and a protein interaction network analysis identified that fibrillarin (FBL) might be an important hub gene. Furthermore, we found that FBL is highly expressed in hepatocellular carcinoma and that its high expression increases the rate of lung metastasis and indicates a poor prognosis. Knockdown of FBL could significantly reduce proliferation and stemness as well as inhibiting the migration and invasion of hepatocellular carcinoma cells. Moreover, we found that FBL might be involved in the regulation of MYC and E2F pathways in hepatocellular carcinoma. Finally, we demonstrated that the knockdown of FBL could suppress hepatocellular carcinoma cell growth in vivo. In conclusion, ribosome-biogenesis-related proteins, especially Fibrillarin, play important roles in lung metastasis from hepatocellular carcinoma.
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Distant metastasis
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Chitotriosidase is synthesized and secreted especially in activated macrophages. The aim of this study was to evaluate chitotriosidase activity in patients with various stages of hepatitis C. The study included a total of 90 patients. The patients were divided into four groups. Group 1 included 54 patients with chronic active hepatitis, Group 2 included 20 patients with recovered HCV, Group 3 included 6 patients with HCV induced hepatocellular carcinoma, and Group 4 included 10 patients with HCV cirrhosis. Chitotriosidase activity was measured with spectrophotometry (SigmaAldrich ®). The mean chitotriosidase activity of the four groups was 0,927u/L (0.804u/L in Group 1, 0.521u/L in Group 2, 3.211u/L in Group 3 and 1.030u/L in Group 4). Chitotriosidase activity was significantly higher in Group 3. ROC analysis, used to evaluate chitotriosidase activity for the diagnosis of hepatocellular carcinoma, showed that chitotriosidase activity of 0,935 was below the curve (CI: 95%; 0,862 - 0,976), which was statistically significant (p= 0,0001). The cut-off value was >1,098 with a sensitivity of 100% and a specifity of 81%. Chitotriosidase activity can be a marker with a high sensitivity and specifity for the diagnosis of hepatocellular carcinoma.
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AIM:To assess the efficacy of low-dose intermittent interferon (IFN) therapy in patients with hepatitis C virus (HCV)-related compensated cirrhosis who had received curative treatment for primary hepatocellular carcinoma (HCC). METHODS:We performed a prospective case controlled study.Sixteen patients received 3 MIU of natural IFNalpha intramuscularly 3 times weekly for at least 48 wk (IFN group).They were compared with 16 matched historical controls (non-IFN group). RESULTS:The cumulative rate of first recurrence of HCC was not significantly different between the IFN group and the non-IFN group (0% vs 6.7% and 68.6% vs 80% at 1-and 3-year, P = 0.157, respectively).The cumulative rate of second recurrence was not also significantly different between the IFN group and the non-IFN group (0% vs 6.7% and 35.9% vs 67% at 1-and 3-year, P = 0.056, respectively).Although the difference in the Child-Pugh classification score between the groups at initial treatment of HCC was not significant, the score was significantly worse at the time of data analysis in the non-IFN group than IFN group (7.19 ± 1.42 vs 5.81 ± 0.75, P = 0.0008).The cumulative rate of deviation from objects of any treatment for recurrent HCC was also higher in the non-IFN group than IFN group (6.7% and 27% vs 0 and 0% at 1-and 3-year, P = 0.048, respectively). CONCLUSION:Low-dose intermittent IFN-alpha therapy for patients with HCV-related compensated cirrhosis after curative HCC treatment was effective by making patients tolerant to medical or surgical treatment for recurrent HCC in the later period of observation.
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Objective
To evaluate the clinical application value of serum high sensitive α-fetoprotein variant ratio (hs-AFP-L3%) in the diagnosis and treatment of hepatocellular carcinoma.
Methods
From October 2016 to March 2018, at Affiliated Hospital of Qingdao University, 160 patients diagnosed with hepatocellular carcinoma, 32 patients with intrahepatic cholangiocarcinoma (ICC), 52 patients with post-hepatitis B liver cirrhosis, 53 patients with chronic hepatitis B and 50 healthy controls were enrolled. The serum levels of hs-AFP-L3% and α-fetoprotein were measured. Mann-Whitney U test, Spearman correlation analysis, Wilcoxon signed rank test and chi-square test were performed for statistical analysis.
Results
The serum levels of hs-AFP-L3% and α-fetoprotein in hepatocellular carcinoma group were 24.90% (4.68% to 61.85%) and 113.45 μg/L (11.18 μg/L to 1 803.48 μg/L), respectively, which were higher than those in ICC group (0.50%, 0.50% to 0.50%; and 2.79 μg/L, 1.72 μg/L to 4.04 μg/L), cirrhosis group (0.50%, 0.50% to 5.25%; and 18.35 μg/L, 3.95 μg/L to 31.93 μg/L), chronic hepatitis group (0.50%, 0.50% to 4.25%; and 2.70 μg/L, 1.80 μg/L to 17.00 μg/L), and healthy control group (0.50%, 0.50% to 0.50%; and 1.94 μg/L, 1.46 μg/L to 2.63 μg/L), and the differences were statistically significant (U=461.00, 1 485.50, 1 141.00, 625.00; 401.50, 2 207.00, 1 254.00, 266.00; all P 0.05). The sensitivity of the combined detection was 82.5%, which was higher than that of the separate detection, and the differences were statistically significant (χ2=24.04 and 18.05, both P 0.05). The sensitivity of hs-AFP-L3% in the diagnosis of patients with α-fetoprotein-negative (α-fetoprotein 0.05).
Conclusions
The sensitivity of hs-AFP-L3% is similar to that of α-fetoprotein in the diagnosis of hepatocellular carcinoma, while the specificity of hs-AFP-L3% is higher than that of α-fetoprotein. The combined detection of the two markers can improve the diagnostic rate of hepatocellular carcinoma. The hs-AFP-L3% has a high diagnostic value in α-fetoprotein-negative hepatocellular carcinoma.
Key words:
Alpha-fetoprotein; Carcinoma, hepatocellular; Fluorescent antibody technique; Variant
Alpha-fetoprotein
Hepatitis B
Intrahepatic Cholangiocarcinoma
Clinical Significance
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Graduate medical education
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Etiology
Hepatitis B
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