Assessment of the Value of Mean Platelet Volume, Des Gamma Carboxy Prothrombin and Alpha Feto Protein in Early Detection of HCC

Abstract

Primary liver cancer is the sixth most commonly diagnosed cancer and the fourth leading cause of cancer mortality worldwide, with an estimated 841,000 cases (9.3 cases per 100,000 person-years) and 782,000 deaths (8.5 deaths per 100,000 person-years) in 2018. HCC being often associated with liver cirrhosis masks symptoms of cancer progression and thus the clinical course of HCC is mostly asymptomatic While the survival of patients with most malignancies has improved over the last decade, the prognosis of HCC remains poor, and most patients have a 5-years survival rate of less than 5% mainly because of the late diagnosis of more than two-thirds of patients diagnosed at advanced stages of disease. Thus, surveillance of populations at-risk may detect tumors at an early stage when curative interventions can be implemented Therefore, it is necessary to identify new serum tumor markers to improve the early diagnosis of HCC. Alpha fetoprotein (AFP) is the most widely used biomarker for HCC surveillance; and was first introduced as a serological marker for HCC in the1960s . However, many patients with non-malignant chronic liver diseases, such as 15–58% of those with chronic hepatitis and 11–47% of those with liver cirrhosis (have elevated AFP concentrations. In contrast, approximately 30–40% of HCCs show normal serum AFP levels. Des-γ-carboxy prothrombin (DCP) induced by vitamin K2 absence/antagonist-II is also known as PIVKA-II (protein induced by vitamin K absence or antagonist-II). DCP is an abnormal prothrombin produced by HCC; it has completely lost the normal prothrombin function and may play an important role in the malignant proliferation of HCC.