The diagnosis of hepatocellular carcinoma (HCC) is very vital. The
aim of this study is to evaluate the role of thyroid binding globulin (TBG)
as a tumor marker in Egyptian hepatocellular carcinoma in comparison
with alpha-fetoprotein (AFP). Twenty patients with cirrhosis were taken
as a cirrhotic control, 20 normal individuals as normal control, in addition
to 30 hepatocellular carcinoma patients.
We concluded that cirrhosis was found in 86.7% of the patients with
hepatocellular carcinoma. Bilharziasis was confirmed in 40% of patients
with hepatocellular carcinoma.There was a significant difference in TBG serum activity levels
between the normal and the cirrhotic controls (P = 0.0003). Also, there
was a significant difference between AFP levels in the cirrhotic group
against that of the normal group (P = 0.0000004).
In the HCC group , TBG serum activity levels were highly
significant when compared with values in the normal group and
significant in the cirrhotic group (P = 0.00012 and 0.011388,
respectively).On the other hand , there was a highly significant difference between
values of AFP in the HCC group and either of the normal and cirrhotic
group (P = 0.009 and 0.00139 , respectively). At the mean + 2 SD cutoff
value of the normal control group (33.33 p g /m1) , TBG had a sensitivity
of 70% which is greater than the corresponding values of AFP at the
widely accepted cutoff value of 500 mg / ml (sensitivity 53.3%). However
, at the same cutoff values , TGB has less specificity.
As regards the relation between TBG and the tumor size, TBG was
above the cutoff value in 6 patients out of 12 (50%), in contrast to AFP
which was above the cutoff value in only 2 patients (16.7%). TBG and
AFP, measured together could detect 23 cases out of 30 patients with
HCC with a sensitivity rate of 76.7% instead of 53.3% and 36.7% for AFP
alone at a cutoff value of 500 and 523 ng/ml respectively and instead of
70% for TBG at a cutoff value of 33.33 p.g/ml. This leads to the
suggestion of the simultaneous use of both TBG and AFP for early and
better detection of hepatocellular carcinoma.
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