head JofIMAB
Journal of IMAB - Annual Proceeding (Scientific Papers)
Publisher: Peytchinski Publishing
ISSN: 1312-773X (Online)
Issue: 2018, vol. 24, issue3
Subject Area: Medicine
DOI: 10.5272/jimab.2018243.2160
Published online: 07 September 2018

Literature review

J of IMAB. 2018 Jul-Sep;24(3):2160-2165
Lejla Mehinović1, *ORCID logo, Zora Vukobrat-Bijedić2ORCID logo, Azra Husić-Selimović3ORCID logo, Amina Kurtović-Kozarić1, 4ORCID logo, Erna Islamagić1ORCID logo, Damir Suljević1, *ORCID logo Corresponding Autoremail, .
1) Department of Biology, Faculty of Science, University of Sarajevo, Bosnia and Herzegovina
2) Polyclinic Al-Tawil, Sarajevo, Bosnia and Herzegovina.
3) Clinic for Gastroenterohepatology, Clinical Centre of the University of Sarajevo, Bosnia and Herzegovina.
4) Department of Clinical Pathology, Cytology and Human Genetics, Clinical Centre of the University of Sarajevo, Bosnia and Herzegovina.
* - those authors contributed equally.

Purpose: In this study, we analyzed biochemical parameters in the serum of patients with a diagnosis of hepatocellular carcinoma (HCC) C and B viral etiology.
Material/Methods: All patients (31 males and 20 females) with a diagnosis of HCC that were treated at the Clinical Centre of the University of Sarajevo were included in this retrospective-prospective study. Serum alpha-fetoprotein was analyzed as a tumor marker, and hepatitis markers included HBs Ag, anti-HBs, anti-HBc, anti-HCV and anti-HB. Spearman test and Kolmogorov-Smirnov test were used for correlation and normality analysis, respectively.
Results: The largest number of patients (68.62%) had cirrhosis of C viral etiology that developed in cancer. Hepatocellular carcinoma was diagnosed more in men than in women (60.78%). The most patients were middle-aged (41-64 years). HCC was present in the right liver lobe at 82.85% HCV and 87.5% HBV patients. Only 6.25% of HBV patients were both liver lobes affected. All biochemical parameters had very high values, especially AFP and γGT. Significant differences for AST and ALT were found between men and women. Serum bilirubin levels (total, direct and indirect) and AP are higher in men than women. Hepatitis markers had high values, and the incidence of HBs Ag (78%) and anti HBc (78.72%) was established.
A positive correlation was established between AFP and other parameters, while a significant difference between AFP and γGT (r = 0.372, p = 0.008) was confirmed. In addition to imaging methods for determining liver cirrhosis and hepatocellular carcinoma, high values of AFP and γGT, are a powerful diagnostic marker for these diseases.

Keywords: alpha-fetoprotein, hepatocellular carcinoma, γGT, HBs Ag, anti-HBc,

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Please cite this article as: Mehinović L, Zora Vukobrat-Bijedić Z, Husić-Selimović A, Kurtović-Kozarić A, Islamagić E, Suljević D. Association between alpha-fetoprotein and other serological markers in patients with hepatocellular carcinoma: one center’s experience. J of IMAB. 2018 Jul-Sep;24(3):2160-2165.
DOI: 10.5272/jimab.2018243.2160

Corresponding AutorCorrespondence to: Damir Suljevic, Department of Biology, Faculty of Science, University of Sarajevo; Zmaja od Bosne, 33-35, 71 000 Sarajevo, Bosnia and Herzegovina; E-mail: suljevic.damir@gmail.com, erna.islamagic@hotmail.com

1. Aronson JK. Biomarkers and surrogate endpoints. Br J Clin Pharmacol. 2005 May;59(5):491-94. [PubMed]
2. Strimbu K, Tavel JA. What are Biomarkers?. Curr Opin HIV AIDS.2010 Nov;5(6):463-66. [PubMed]
3. Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM. Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer. 2010 Dec;127(12):2893–971. [PubMed]
4. Marrero JA, Feng Z, Wang Y, Nguyen MH, Befeler AS, Roberts LR, et. al. Alpha-fetoprotein, des-gamma carboxyprothrombin, and lectin-bound alpha-fetoprotein in early hepatocellular carcinoma. Gastroenterology. 2009 Jul;137(1):110-8. [PubMed]
5. Forner A, Reig M, Bruix J. Alfafetoprotein for hepatocellular diagnosis: The demise of briliant star. Gastroenterology. 2009 Jul;137(1):26-9. [PubMed]
6. El-Garem H, Abdel-Hafez H, Foaud A, Al Akel W, Atia Met E, Salah M, et al. Tissue biomarkers in the early detection of hepatocellular carcinoma among egyptian patients with chronic hepatitis C: A possible genetic profile. Br J Med Med Res. 2013; 3(4):1858-70. [CrossRef]
7. Hosaka T, Suzuki F, Kobayashi M, Seko Y, Kawamura Y, Sezaki H, et al. Long-term entecavir treatment reduces hepatocellular carcinoma incidence in patients with hepatitis B virus infection. Hepatology. 2013 Jul;58(1):98–107. [PubMed]
8. Yamashiki N, Sugawara Y, Tamura S, Kaneko J, Yoshida H, Aoki T, et al. Diagnostic accuracy of β-fetoprotein and des-γ-carboxy prothrombin in screening for hepatocellular carcinoma in liver transplant candidates. Hepatol Res. 2011 Dec;41(12):1199-207. [PubMed] [CrossRef]
9. Sterling RK, Wright EC, Morgan TR, Seeff LB, Hoefs JC, Di Bisceglie AM, et al. Frequency of elevated hepatocellular carcinoma (HCC) biomarkers in patients with advanced hepatitis C. Am J Gastroenterol. 2012 Jan;107(1):64-74. [PubMed] [CrossRef]
10. Suljevic D, Mehinovic L, Alijagic A. Hepatitis and biochemical markers in correlation with alpha-fetoprotein as a diagnostic indicator for the HBV and HCV differentiation. Alban Med J. 2016;3:13-20.
11. El-Serag HB, Rudolph KL. Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology. 2007 Jun;132(7):2557-76. [PubMed] [CrossRef]
12. Fattovich G, Stroffolini T, Zagni I, Donato F. Hepatocellular carcinoma in cirrhosis: incidence and risk factors. Gastroenterology. 2004 Nov;127(5 Suppl 1):35-50. [PubMed] [CrossRef]
13.Bilić-Komarica E, Vukobrat-Bijedić Z, Dautović-Krkić S. [Possible predictors of hepatocellular carcinoma in chronic viral hepatitis B and C etiology.] [in Bosnian] Medical Journal. 2012; 18(3):159-64.
14. Hernandez JC, Samanda M, Roque A, Cruz Y, Howland I, Fernandez I. Diagnostic value of alpha-fetoprotein for hepatocellular carcinoma. Biotecnol Apl. 2011; 28(1):34-39.
15. Seef LB, Hoofnagle JH. Epidemiology of hepatocellular carcinoma in areas of low hepatitis B and hepatitis C endemicity. Oncogene. 2006 Jun;25(27):3771-7. [PubMed] [CrossRef]
16. Karin M, Bevanda M, Babic E, Mimica M, Bevanda-Glibo D, Volaric M, et al. Correlation between  biochemical and histopathological parameters in patients with hronic hepatitis C treated with pegylated interferon and ribavirin. Psychiatr Danub. 2014; 26(Suppl 2):S364-69.
17. Bashir MF, Haider MS, Rashid N, Riaz S. Association of Biochemical Markers, Hepatitis C Virus and Diabetes Mellitus in Pakistani Males. Trop J Pharm Res. 2013;12(5):845-50. [CrossRef]
18. Tangkijvanich P, Mahachai V, Suwangool P, PoovorawanY. Gender difference in clinicopathologic features and survival of patients with hepatocellular carcinoma. World J Gastroenterol. 2004 Jun;10(11):1547-50. [PubMed] [CrossRef]
19. Peng SY, Chen WJ, Lai PL, Jeng YM, Sheu JC, Hsu HC. High alpha-fetoprotein level correlates with high stage, early recurrence and poor prognosis of hepatocellular carcinoma: significance of hepatitis virus infection, age, p53 and beta-catenin mutations. Int J Cancer. 2004 Oct 20;112(1):44-50. [PubMed] [CrossRef]
20. Cedrone A, Covino M, Caturelli , Pompili M, Lorenzelli G, Villani MR, et al. Utility of alpha-fetoprotein (AFP) in the screening of patients with virus-related chronic liver disease: does different viral aetiology influence AFP levels in HCC? A study in 350 Western patients. Hepatogastroenterology. 2000 Nov-Dec;47(36):1654-8. [PubMed].

Received: 15 January 2018
Published online: 07 September 2018

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