title: The role of chemokine CC ligand 20 in patients with liver cirrhosis and hepatocellular carcinoma.
abstract: OBJECTIVE
  To evaluate the role of chemokine CC ligand 20 (CCL20) as a biomarker for hepatocellular carcinoma (HCC).
  
  
  METHODS
  Ninety patients in four groups were enrolled in this prospective cross-sectional study: 30 with HCC (group I), 30 with liver cirrhosis (group II), 15 with hepatitis C virus infection (group III), and 15 healthy blood donors as controls. Alpha fetoprotein (AFP), CCL20 and vascular endothelial growth factor (VEGF) were measured in all groups.
  
  
  RESULTS
  Serum levels of CCL20 were significantly different among the study groups (F=230.979, p<0.001). The highest level was found in HCC patients (57.305 ± 6.386 pg/mL) followed by patients with cirrhosis (45.999 ± 5.165 pg/mL) compared with 22.781 ± 5.986 pg/mL and 18.585 ± 3.554 pg/mL in asymptomatic patients with HCV infection and controls, respectively. In HCC patients, CCL20 significantly correlated with VEGF (r=0.559, p=0.001), AFP (r=0.814, p<0.001), Child score (r=0.748, p<0.001), and tumor size (r=0.825, p<0.001). The cutoff value of CCL20 for the detection of HCC in HCV-infected patients was 54 pg/mL with 93.1% accuracy, 89.6% negative predictive value, 92.6% positive predictive value, 83.3% sensitivity, and 93.3% specificity. In patients with cirrhosis, CCL20 significantly correlated with VEGF (r=0.455, p=0.011), AFP (r=0.975, p<0.001), and Child score (r=0.977, p<0.001).
  
  
  CONCLUSIONS
  CCL20 may be used for the detection of HCC in HCV-infected patients with comparable specificity and higher sensitivity than AFP.
authors.affiliation: Department of Tropical Medicine and Infectious Diseases, Tanta University Hospitals, Tanta Faculty of Medicine, Tanta - Egypt.
authors.forename: Hanan H
authors.initials: HH
authors.lastname: Soliman
authors.forename: Hala
authors.initials: H
authors.lastname: Nagy
authors.forename: Nesreen
authors.initials: N
authors.lastname: Kotb
authors.forename: Mohamed A
authors.initials: MA
authors.lastname: Alm El-Din
mesh_terms: D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D054418:Chemokine CCL20 / Q000097:blood*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D006801:Humans; D008103:Liver Cirrhosis / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D008113:Liver Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D011446:Prospective Studies; D042461:Vascular Endothelial Growth Factor A / Q000097:blood; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D014408:Biomarkers, Tumor; D054418:Chemokine CCL20; C467484:VEGFA protein, human; D042461:Vascular Endothelial Growth Factor A; D000509:alpha-Fetoproteins