الفهرس | Only 14 pages are availabe for public view |
Abstract Introduction:AFP is the most widely used tumor biomarker available for the detection of HCC. However, it has some limitations such as low sensitivity and specificity. AFP has three glycoforms, each with different binding capability to lectin Lens culinaris agglutinin (LCA): AFP-L1 (non-binding fraction), AFP-L2 (weak binding fraction), and AFP-L3 (binding fraction). AFP-L3 is specifically increased in HCC because it is derived only from cancer cells, it has been considered a more specific biomarker for HCC.The aim of work:To study the prognostic utility of AFP-L3 in HCC as one of the therapeutic intents of TACE.Research Plan:This study was conducted on HCV related cirrhotic patients with or without HCC selected from the Outpatient Hepatology Clinics and HCC Clinic, SMH, Mansoura University, Egypt. Fifty patients were included and recruited into two groups. group (A): included 35 patients with HCC who are eligible for TACE and group (B): included 15 cirrhotic patients without HCC.All studied groups were subjected to thorough clinical history and examination. Basic laboratory investigations in addition to tumor markers (AFP, AFP-L3 & AFP-L3 percent) were done. Radiological diagnosis of HCC was based on US and triphasic CT of the abdomen. Patients in group (A) were subjected for assessment of treatment response by abdominal triphasic CT, re-assessment of AFP, AFP-L3 & AFP-L3 percent. Results: Univariate analysis showed that AFP-L3 percent change after TACE was the only predictor of complete response among the three examined markers. Decline by ≥ 3.915% after TACE 18.7 times higher odds that the patient will exhibit complete response by CT.Conclusion : Our study demonstrated that AFP-L3 percent change & INR change were independent predictors of complete response. |