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The Egyptian Journal of Internal Medicine
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Association of serum growth differentiation factor 15 and hepatocellular carcinoma in Egyptian patients

The Egyptian Journal of Internal Medicine volume 31, pages 57–63 (2019)Cite this article

Abstract

Background

Liver cirrhosis and hepatocellular carcinoma (HCC) are consequences of chronic hepatitis C virus (HCV) infection. HCC is one of the fastest rising causes of cancer-related mortality. This dismal prognosis is related to late diagnosis with currently available screening methods. The aim of our study was to evaluate the diagnostic power of serum growth differentiation factor (GDF) 15 in HCC detection and its ability to distinct HCC from cirrhosis in chronic hepatitis C Egyptian patients.

Patients and methods

Ninety participants were included in the study; 30 patients with HCV-cirrhosis, 30 patients with HCV-Cirrhosis and HCC, and 30 gender and age-matched healthy subjects as the control group. The patients were subjected to history taking, clinical examinations, routine laboratory analysis, and α-fetoprotein (AFP) determination. Serum GDF15 was measured using an enzyme-linked immunosorbent assay kit.

Results

The mean level of GDF15 in HCV-cirrhosis patients was 140.28±128.66 pg/ml, in HCV-HCC patients 154.45±123.74 pg/ml, and in the control group it was 81.19 ±42.53 pg/ml. Statistically significant difference in GDF15 level was found between HCV-HCC patients and controls, P=0.012, while no statistically significant difference was found on comparing HCV-cirrhosis patients to controls or to HCV-HCC patients, P=0.064 and 0.473, respectively. The cut-off value of GDF15 to discriminate HCV-HCC patients from controls was 122.3 pg/ml with 53.3% sensitivity and 86.7% specificity and an area under the receiver operating characteristic (AUROC) of 0.692. AFP at a cut-off value of 20.85 ng/l was able to discriminate HCV-HCC patients from HCV-cirrhosis patients with 73.3% sensitivity and 73.3% specificity and an AUROC of 0.744. AUROC for combined AFP and GDF15 showed lower performance than AFP alone in discrimination of HCV-HCC from HCV-cirrhosis patients (AUROC=0.642).

Conclusion

GDF15 is not a potential diagnostic marker for the distinction of HCC from cirrhosis in chronic hepatitis C Egyptian patients.

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Authors and Affiliations

  1. Department of Internal Medicine and Hepatogastroenterology, Faculty of Medicine, Cairo University, Cairo, 11562, Egypt

    Mohamed-Naguib Wifi, Ahmed Y. Hassan, Maha A. Hussien MD & Mohamed G. Sokar

  2. Department of Clinical and Chemical Pathology, Faculty of Medicine, Cairo University, Cairo, Egypt

    Rania A. Zayed & Nevine Fouad

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  1. Mohamed-Naguib Wifi
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  2. Rania A. Zayed
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  3. Nevine Fouad
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  4. Ahmed Y. Hassan
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  5. Maha A. Hussien MD
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Correspondence to Maha A. Hussien MD.

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Wifi, MN., Zayed, R.A., Fouad, N. et al. Association of serum growth differentiation factor 15 and hepatocellular carcinoma in Egyptian patients. Egypt J Intern Med 31, 57–63 (2019). https://doi.org/10.4103/ejim.ejim_39_18

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