Evaluation of Serum Thioredoxin as a Diagnostic Marker for Hepatocellular Carcinoma in Comparison to AFP

Abstract

Hepatocellular carcinoma (HCC) is one of the most common malignant tumors worldwide. In Egypt, the incidence of HCC has doubled in the past 10 years and it is now the second most incident and lethal cancer in men. It has been recognized that AFP has a low sensitivity in detection of HCC, and that AFP level often increases in the absence of HCC. TRX has been reported to be expressed in the majority of hepatocellular carcinoma as a diagnostic marker. so the aim of this study was to evaluate the diagnostic value of TRX as a marker for HCC. The present study included fifty patients, twenty five patients of them with hepatocellular carcinoma , fifteen patients with liver cirrhosis in addition to ten persons who are apparently healthy individuals served as control group. All patients were subjected to history taking ,physical examination ,laboratory investigatins including (CBC , ALT , AST , GGT , HBs Ag , HCVAb) , AFP (ELISA) and TRX (ELISA). Radiological investigation (criteria of liver cirrhosis by abdominal ultrasound,criteria of HCC by triphasic CT). Summary  88 Results were statisticaly analysed. Results showed that Hepatocellular carcinoma tends to occur at higher age when compared with cirrhosis group and was more common in males than females. Hepatic focal lesions tends to be large, single, rounded, more frequent in right lobe. Most cases of HCC were stage II Okuda and were present at advanced Tokyo stage. Our study showed that cutoff value of TRX of 89.4 is the best as a marker of HCC with sensitivity of 96.0 ,specificity of 72.0% , PPV of 77.4% , NPV of 94.7% and accuracy of 84.0%. Also cutoff value of TRX of 82.55 is the best as a marker of liver cirrhosis with sensitivity of 85.0 ,specificity of 80.0% , PPV of 94.4% , NPV of 57.1% and accuracy of 84.0% denoting that thioredoxin can be a good marker for evaluation of HCC.