Study for the significance of Osteopontin vs Alpha Feto Protein as a diagnostic marker for Hepatocellular carcinoma in cirrhotic patients with HCV

Abstract

Hepatocellular carcinoma (HCC) is the fifth most common tumor and the third most common cause of cancer-related deaths worldwide. HCC incidence has increased sharply over recent decades and this has been partially attributed to chronic HCV infection. Early stage of HCC can be treated with potentially curative procedures, such as resection, percutaneous ablation, and transplantation. Median survival of patients with early HCC reaches 50–70% at 5 years after resection, liver transplantation, or local ablation. Owing to the lack of reliable clinical HCC markers, fewer than 20% of patients are diagnosed at a stage where curative treatment can be performed. The poor outcome of patients with HCC is related to the late detection with more than two-thirds of patients diagnosed at advanced stages of disease. Because the poor outcomes of HCC patients are often related to late detection, recent practice guidelines recommend continued surveillance for patients at high risk. Currently, α-fetoprotein (AFP) is the most validated serological marker for HCC. Even though AFP’s performance in early stage HCC are deficient, the sensitivity and specificity of plasma AFP detection ( > 20 ng/mL) in screening tests were set at about 50% and 85%, respectively. According to the new update of the American Association for the Study of Liver Diseases (AASLD) practice guideline for HCC, AFP alone should not be used for HCC screening unless ultrasound is not available. Consequently, a series of additional biomarkers for HCC screening has been suggested.