Background & Study Aims : Alpha fetoprotein (APP) is considered as the reference biological marker for
Hepatocellular carcinoma (HCC); however the lack of increase of APP in some cases justifies the search for new
markers. Many tumor cells, including hepatic tumor cells produce and release plasma plasminogen activator
inhibitor antigen (PAW), fibrinogen and plasma tissue- hype plasminogen activator antigen(t-PA). The aim
of this work is to determine the reliability of PAI-1, t-PA, fibrinogen in detection of primary liver cancer as
compared to or combined with the established tumor marker APP.
Patients & Methods: Group I consists of twenty cirrhotic patients of post viral hepatitis of all child
pough grades A, B, C. Group II consists of 45 patients and divided into subgroup A with a tumor size <5cm
and subgroup B with tumor size >5cm.Group III consists of 10 control persons. Cases underwent clinical,
laboratory, gastroendoscopic examination (group I and ll only) and histopathological examination for liver
biopsies (group II only). Plasma levels of PM-I, t-PA, fibrinogen and APP were done for all groups.
Results : Plasma levels of PM-I, fibrinogen and t-PA antigens were higher in patients with tumor size >5cm
than <5 cm tumor sized patients. Specificity of PAI-1 was 80% and sensitivity was 57.78% for detection of
HCC, Specificity ofAFP was 80% and sensitivity was 66.6%. Specificity of fibrinogen was 70% and sensitivity
was 64.4%. In association of APP, PSI-1 and fibrinogen sensitivity were,84.4% and specificity were 100%
Conclusion : PAT-I, APP and fibrinogen can be used as markers for detection of HCC with a good sensitivity
and specificity ratio especially when combined with each others and they have a competitor cost effectivnes. |
