Comparison of serum survivin and alpha fetoprotein in Egyptian patients with hepatocellular carcinoma associated with hepatitis C viral infection.
BACKGROUND
Survivin is specific antiapoptotic gene product expressed in a variety of human neoplasms whose overexpression might assist in early diagnosis and as a prognostic marker.


OBJECTIVE
The aim was to evaluate the plasma levels of survivin and alpha fetoprotein in patients with chronic hepatitis C viral infection (HCV) with and without hepatocellular carcinoma (HCC).


METHODS
70 subjects were divided into: a control group (Group I) (20 healthy volunteers) and two patients groups: Group II, HCV group (20 patients); and Group III, HCC with HCV(30 patients).


METHODS
Thorough physical examination, ultrasonography of the abdomen, laboratory investigations (liver profile, anti-HCV antibodies, hepatitis B surface antigen, Alpha fetoprotein (chemiluminometry) and Survivin (ELISA)) were performed.


RESULTS
There was a significant increase in survivin level in HCV patients (Group II) when compared to the control group (p=0.039), along with a significant increase in AFP in Groups II and III when compared to Group I (P<0.001 for both). AFP also distinguished between the two HCV groups. The best generated cut off value for AFP was 10.9 ng/ml and for survivin 13.7 pg/ml. Serum survivin diagnostic sensitivity was 53.3%, diagnostic specificity 62.5% and efficiency 58.6%, in contrast to 100%, 92.5% and 95.7%, respectively, for AFP.


CONCLUSIONS
While survivin showed significant increase in the HCV group, its diagnostic performance was lower and it proved to be less reliable as a tumor marker for HCC than did AFP.
Department of Chemical Pathology, Medical Research Institute, Alexandria University, Egypt. silentnight2030@yahoo.com
H A
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El-Attar
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Kandil
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El-Kerm
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El-Ghandour
D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood*; D004534:Egypt; D005260:Female; D006526:Hepatitis C / Q000097:blood* / Q000150:complications; D006801:Humans; D051034:Inhibitor of Apoptosis Proteins; D008113:Liver Neoplasms / Q000097:blood* / Q000150:complications / Q000175:diagnosis; D008297:Male; D008869:Microtubule-Associated Proteins / Q000097:blood*; D008875:Middle Aged; D011379:Prognosis; D012372:ROC Curve; D012680:Sensitivity and Specificity; D000077022:Survivin; D000509:alpha-Fetoproteins / Q000378:metabolism*
C107489:BIRC5 protein, human; D014408:Biomarkers, Tumor; D051034:Inhibitor of Apoptosis Proteins; D008869:Microtubule-Associated Proteins; D000077022:Survivin; D000509:alpha-Fetoproteins