title: Enhanced detection of hepatocellular carcinoma.
abstract: BACKGROUND
  Tumor markers in the early detection of tumors are promising tools that could improve the control and treatment of tumors. While alpha-fetoprotein (AFP) is a commonly used tumor marker in the detection of hepatocellular carcinoma (HCC), its sensitivity and specificity are insufficient to detect HCC in all patient samples.
  
  
  METHODS
  We compared AFP with serum levels of vascular endothelial growth factors (VEGF and VEGF-A), insulin-like growth factor-2 (IGF-II), and the activity of the lysosomal enzyme alpha-L-fucosidase (AFU) in the sensitivity of detection of HCC and cirrhosis in Egyptian patients.
  
  
  RESULTS
  The sensitivity of tumor detection using AFP was 68.2%. This level of detection was increased to 88.6% when AFP was evaluated in conjunction with AFU. The combined use of AFP and VEGF increased the sensitivity of detection to 95.5% in patients with HCC. The combination of the three markers yielded 100% detection sensitivity. VEGF-A showed a low specificity (20%), and IGF-II showed extremely low sensitivity (4.5%).
  
  
  CONCLUSIONS
  We suggest that AFU or VEGF or both be measured with AFP to improve the detection sensitivity of HCC.
authors.affiliation: Biophysics Department, Faculty of Science, Cairo University, Egypt.
authors.forename: Motawa E
authors.initials: ME
authors.lastname: el-Houseini
authors.forename: Mohammed S
authors.initials: MS
authors.lastname: Mohammed
authors.forename: Wael M
authors.initials: WM
authors.lastname: Elshemey
authors.forename: Tarek D
authors.initials: TD
authors.lastname: Hussein
authors.forename: Omar S
authors.initials: OS
authors.lastname: Desouky
authors.forename: Anwar A
authors.initials: AA
authors.lastname: Elsayed
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood*; D005260:Female; D006801:Humans; D007335:Insulin-Like Growth Factor II / Q000378:metabolism; D008113:Liver Neoplasms / Q000097:blood*; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D042461:Vascular Endothelial Growth Factor A / Q000097:blood; D000509:alpha-Fetoproteins / Q000378:metabolism; D005644:alpha-L-Fucosidase / Q000097:blood
chemical_list: D014408:Biomarkers, Tumor; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000509:alpha-Fetoproteins; D007335:Insulin-Like Growth Factor II; D005644:alpha-L-Fucosidase