Evaluation of ß2-Microglobulin in Patients with Liver Cirrhosis and Hepatocellular Carcinoma

Abstract

HCC is a major type of primary liver cancer and one of the most frequent human malignant neoplasm. It is estimated to cause more than a quarter of a million deaths each year throughout the world. Because of the very high prevalence of HCV in the Egyptian population, it accounts for most chronic liver disease and HCC cases. This study was conducted to verify the reliability of ß2-MG as a marker for diagnosis of HCC and its significance in evaluation of severity of liver cirrhosis. 90 subjects were recruited and were divided into 3 groups: group I included 40 patients with HCV related chronic liver disease and HCC, group II included 30 patients with HCV related chronic liver disease and group III which included 20 healthy subjects who served as a control group. Serum ß2-MG level was measured in peripheral blood samples by ELISA method and there was a significant rise in its level in group I than in group II and III. There was a highly positive correlation between serum ß2-MG level and S. bilirubin, INR, ALT but it was negatively correlated with total protein and S. albumin. Regarding the correlation between the Child-Pugh Staging System and the mean ß2-MG level, ß2-MG level was insignificantly higher in Child-Pugh class C (69.2%) than Class A and B (50% and 33.3% respectively). At a cut off value of 3 mcg/ml; ß2-MG had a sensitivity of 92.5% , a specificity of 100% , a positive predictive value of 100% , a negative predictive value 87% and an overall accuracy of 95% in detection of HCC (considering healthy subjects as controls). At a cut off value 4.7 mcg/ml; ß2-MG level had a sensitivity of 60 %, a specificity of 73.3%, a positive predictive value of 75 %, a negative predictive value 57.9 % and an overall accuracy of 65.7 % in detection of HCC (considering patients with liver cirrhosis as controls).