Liver cancer is the fifth most common cancer (749,000 new cases), the third cause of cancer related death (692,000 cases), and accounts for 7% of all cancers .HCC represents more than 90% of primary liver cancers and is a major global health problem.
Major risk factors for hepatocellular carcinoma include chronic HBV or HCV infection, alcoholic and nonalcoholic fatty liver disease. Less common causes include hereditary hemochromatosis, alpha1-antitrypsin (α1AT) deficiency, autoimmune hepatitis, porphyria and Wilson’s disease. The distribution of these risk factors among patients with hepatocellular carcinoma is highly variable, depending on geographic region and race or ethnic group.
The prognosis of HCC remains poor, and most patients have a 5-years survival rate of less than 5% mainly because of the late diagnosis. So, there is a need for detection methods.
AFP is the most established tumor marker in HCC and the gold standard by which other markers for the disease are judged.
Mean platelet volume (MPV) is a parameter of routine blood count which was actively investigated in many liver diseases .MPV was found to be related to metabolic syndrome, advanced liver fibrosis and ascetic fluid infection.
This prospective study was designed to evaluate the diagnostic usefulness of MPV and MPV/PC ratio in HCC patients due to chronic hepatitis C infection.
This study was conducted on 120 Egyptian participants attending or admitted to the Department of Hepatology, Gastroenterology and Infectious Diseases, Benha University Hospital during the period from April 2014 to March 2016 after approval of Benha university ethical committee. They were divided into 4 equal groups: 30 healthy subjects, 30 patients with chronic viral hepatitis without cirrhosis , 30 cirrhotic patients without HCC and 30 cirrhotic patients with HCC due to CHC .MPV, MPV/ PC ratio & AFP were evaluated in all groups. Triphasic CT was done for HCC patients to confirm the diagnosis. Liver biopsy was done for CHC patients to confirm the diagnosis.
All patients included in the study, after assigning in an informed consent form, were subjected to full history taking, thorough clinical examination, routine laboratory and radiological investigations.
In th present study we found that:
• HCC group showed male predominance with male to female ratio 4:1.
• The mean age was higher in cirrhotic group without HCC (group III) than HCC, HCV and control groups (59 ± 9.54 years vs 57.53±8.18 years, 37.27±10.32 years and 27.37 ±9.78 years) respectively with no statistically significant difference between HCC and cirrhotic groups. (p=0.52).
• AFP was highly elevated in HCC group than in cirrhotic, chronic hepatitis and control groups with highly statistically significant difference (P 62.3 ng/dl level had much higher sensitivity ( 90 %), specificity (98.33%) and area under curve (AUC) was 0.9.
So, MPV and MPV/PC ratio are less sensitive and specific than AFP in diagnosis of HCC.
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