Vitronectin (VTN): A Novel Diagnostic And Prognostic Marker for Hepatocellular Carcinoma (HCC) On Top Of Chronic Hepatitis C Virus Related Diseases

Abstract

Hepatocellular carcinoma (HCC) is the fifth most common cancer worldwide and the most common form of primary liver cancer. Aim of the study: to study the level of serum vitronectin (VTN) compared to AFP in diagnosis and prognosis of hepatocellular carcinoma on top of HCV-related liver diseases. Patients and Methods: This prospective observational study included a total number of 60 subjects who were divided into 4 groups: Group 1: include 10 normal persons. Group 2: included 10 patients who have Hepatitis C Virus infection. Group 3: included 20 cirrhotic patients. Group 4: included 20 patients with HCC (on top of hepatitis C virus related cirrhosis), in which we tested them for vitronectin before intervention and after intervention within 3 months. Results: The mean age of the cases showed high statistically significant difference between the study groups (P < 0.001).There were a total number of 29 males and 31 females with significant difference in the sex distribution between the study groups. 80% of the cases in HCC group were males. The median level of AFP in group 4 (HCC patients) was 110 IU/ml which was higher than its median value in the other study groups with high level of significance between the study groups. The median level of vitronectin levels in the different study groups didn’t reveal a statistically significant difference between the different study groups. The serum level of vitronectin in group 3 (cirrhotic patients) has no statistically significant difference between the three subgroups.. Conclusions: Chronic HCV infection and its serious complicatons specially HCC are still representing a health challenge in Egypt, reflecting the wide HCV prevalence and late diagnosis. Over a decade, there was nearly a two fold increase in the proportion of HCC among chronic liver disease patients in Egypt. Serum AFP alone has an unreliable role in HCC surveillance. AFP has low sensitivity as it may be normal in up to 40% of HCC cases especially early stages of the tumor, and low specificity as its levels may be elevated in conditions other than HCC as cirrhosis or exacerbation of chronic hepatitis or even in some cases of cholangiocarcinoma. AFP is useful in clinical practice in screening and diagnosis of HCC in association with US and CT. According to our study, we can't use Vitronectin in diagnosis and prognosis of HCC on top of cirrhosis related to HCV +ve infection. It didn’t reveal a statistically significant difference between the different study groups in our study.