Serum Arginase as a Tumor Marker for Hepatocellular Carcinoma

Abstract

H epatocellular carcinoma (HCC) is the fifth most common form of cancer worldwide and the third most common cause of cancer-related deaths. HCC often occurs in the background of a cirrhotic liver. HCC is now increasingly recognized at a much earlier stage as a consequence of the routine screening of patients with known cirrhosis, using cross-sectional imaging studies and serum alpha-fetoprotein measurements. Although the role of AFP in the diagnosis of advanced HCC is well recognized, at least one-third of small HCC and 30% of advanced HCC will be missed unless another diagnostic tool is used. AFP assessment and liver ultrasound can be a diagnostic factor in screening and follow up of the patients at risk of HCC. The AFP sensitivity differs on the basis of selected cut off level in many countries. Results of many studies showed that serum AFP level more than 400-500 ng/ml is specific for HCC, but its range between 20-200 ng/ml is non-specific in diagnosis. However, serum (AFP) levels are not increased in some HCC patients and it may be increased in to chronic benign Liver diseases as liver cirrhosis. The sensitivity and specificity of AFP as a tumor marker for HCC is augmented by search for other serum markers to increase the diagnostic yield.