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The Egyptian Journal of Internal Medicine
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Noninvasive prediction of hepatitis C-associated hepatocellular carcinoma using circulating apolipoproteins

The Egyptian Journal of Internal Medicine volume 31, pages 451–457 (2019)Cite this article

Abstract

Background and aims

Hepatocellular carcinoma (HCC) is one of the leading causes of cancer-related mortality worldwide. We investigated the potential usefulness of circulating apolipoproteins (Apo-A1 and Apo-A4) in HCC screening and diagnosis.

Patients and methods

We included 60 adult patients with hepatitis C virus-related chronic liver disease including HCC, in addition to 20 healthy controls. Patients were stratified into three equal groups, with 20 patients each: chronic hepatitis C, posthepatitis C cirrhosis (liver cirrhosis), and HCC. All patients and controls underwent full clinical assessment, laboratory investigations, and evaluation of candidate apolipoproteins by enzyme-linked immunoassay.

Results

Significantly higher Apo-A1 and Apo-A4 levels were detected in patients with HCC than in those with liver cirrhosis (P<0.001). Receiver operator characteristic curve showed that for HCC diagnosis, a cutoff of 78.6 mg/dl for Apo-A1 yielded 90% sensitivity and 100% specificity and a cutoff of 16.5 mg/dl for Apo-A4 yielded 85% sensitivity and 80% specificity. Furthermore, within HCC group, Apo-A1 was significantly higher in patients with small HCC (>2 cm) than those with large tumors (P=0.01). Lower Apo-A1 level correlated significantly with pylethrombosis (P=0.007).

Conclusion

Apo-A1 and Apo-A4 are novel biomarkers for HCC screening and diagnosis, with a special discriminative ability for Apo-A1 for those with small tumors and those with pylethrombosis.

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Authors and Affiliations

  1. Department of Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University, Cairo, 11652, Egypt

    Hasan El Garem, Gamal Esmat, Rabab Salama, Dalia Omran & Heba Omar MD, GCSRT

  2. Department of Medical Biochemistry, Faculty of Medicine, Cairo University, Cairo, Egypt

    Hanan Fouad & Dina Sabry

  3. Department of Department of Hepatogastroenterology, Egypt Air Hospital, Cairo, Egypt

    Yomna Mostafa

Authors
  1. Hasan El Garem
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  2. Gamal Esmat
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  3. Rabab Salama
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  4. Hanan Fouad
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  5. Dina Sabry
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  6. Yomna Mostafa
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  7. Dalia Omran
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  8. Heba Omar MD, GCSRT
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Corresponding author

Correspondence to Heba Omar MD, GCSRT.

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El Garem, H., Esmat, G., Salama, R. et al. Noninvasive prediction of hepatitis C-associated hepatocellular carcinoma using circulating apolipoproteins. Egypt J Intern Med 31, 451–457 (2019). https://doi.org/10.4103/ejim.ejim_26_19

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  • DOI: https://doi.org/10.4103/ejim.ejim_26_19

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