Serum Adiponctin Level in Patients with Chronic HCV and Hepatocellular Carcinoma with and Without Intervention

Abstract

Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide and it is one of the major causes of death, because of its high frequency and poor prognosis. Hepatocellular carcinoma is now a rather common malignancy in Egypt which usually develops on top of liver cirrhosis secondary to viral infection, as hepatitis C viruses increased the risk of HCC in the Egyptian patients. Tumor markers are substances synthesized and secreted by the malignant cells and they are not normally found and they are not biologically active if present as they present in much smaller amounts, few of them are produced in a sufficient large proportions, so they can be used as serum markers of tumors and they become helpful in screening, diagnosis and follow up of cases. Adiponectin is a polypeptide hormone formed of 244 amino acid secreted by adipocytes,Hepatocytes, cardiac muscle, and endothelial cells. It is overexpressed in a variety of human tumors, including carcinomas of stomach, breast, prostate, lung, colon and liver. The aim of this study is to verify the possibility of using the plasma Adiponectin level as a biomarker for hepatocellular carcinoma and also as a prognostic marker. The study included 50 subjects divided into three groups: group I was 20 patients with cirrhosis post HCV group IIa was 15 patients with Hepatocellular Carcinoma post HCV and group IIb was 15 patients with hepatocellular carcinoma post chemo-embolization. The plasma Adiponectin level was significantly lower in group IIa patients (with HCC post HCV), than in the group I patients (only cirrhotic post HCV) the control group. Adiponectin showed direct significant correlation with TAG in HCC patient group and HDL In cirrhotic post HCV group and negative significant correlation with BMI in the same group. The sensitivity and specificity of Adiponectin for selective detection of the HCC group over the non-HCC group (HCV group) were 90% and 75%, respectively, at a cut-off value of >6.5 microgram/mL. So plasma Adiponectin level appears to be additional marker for HCC detection.