HCC Biomarker Egypt
First Evaluation of HCC biomarkers AFP-L3% and DCP in Egypt
During a seminar at May 14th 2009 in Cairo, Prof. Dr. Imam Waked from the National Liver Institute in Menoufiya presented first study results about the HCC biomarkers AFP-L3% und DCP.
First Prof. I. Waked explained the status of HCC in Egypt. In the fifteen years between 1993 and 2008 a threefold increase in the incidence of HCC has been observed in Egypt. Today it is the third most common type of cancer in the population. Nevertheless surveillance of patients at high risk of developing HCC is not very actively practiced in Egypt. For example at the National Liver Institute only 11% of HCC patients were diagnosed during planned prospective screening due to liver cirrhosis.
Prof. I. Waked investigated the diagnostic performance of AFP, AFP-L3 and DCP in 89 patients with proven HCC and 45 patients with liver cirrhosis. These markers were determined by the fully-automated LiBASys (Liquid-phase Binding Assay System) instrument in the lab of Prof. Dr. Hala El-Said and Prof. Dr. Ahmed Raouf from the Clinical Biochemistry Department of the National Liver Institute. Distribution patterns of the test results indicated that AFP, AFP-L3% and DCP don’t correlate with each other, as expected. Using cutoff values of 200 ng/ml for AFP, 10% for AFP-L3 and 7,5 ng/ml for DCP, the individual tests showed a similar diagnostic performance with sensitivities ranging from 49,5% to 55,0% and specificities from 95,6% to 97,8%. The combined use of all three markers resulted in a significantly increased sensitivity of 70,1% and a still higher specificity of 97,8%. The positive likelihood ratio was calculated to be the highest for this combination with 32,5.
As a conclusion Prof. I. Waked emphasized the importance of screening of patients at high risk for HCC development. The performance of the three tests was satisfactory in this study and the best criteria as screening test was found for the panel of all three tests together. Further data analysis to correlate the marker results with clinical findings is still ongoing.
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