title: Comparison of AFP-L3 and p53 Antigen Concentration with Alpha-Fetoprotein as Serum Markers for Hepatocellular Carcinoma.
abstract: BACKGROUND
  Hepatocellular carcinoma (HCC) has the worst prognosis among all major cancers, largely due to the lack of sensitive diagnostic markers. We aimed to compare three HCC tumor markers, alpha-fetoprotein (AFP), p53, and AFP-L3%, to evaluate whether measuring serum p53 levels and AFP-L3% has an additive diagnostic value for detection of HCC.
  
  
  METHODS
  A total of 86 patients with chronic liver diseases were included. HCC was detected in 68 (79.1%) patients. Twenty healthy age-matched volunteers served as healthy controls. Serum concentrations of AFP, AFP-L3, and p53 protein were measured. The correlations between the three markers with status of viral hepatitis, liver function tests, and Child-Pugh scores were determined.
  
  
  RESULTS
  HCC patients showed significantly higher percentages of cirrhosis and Child-Pugh grade C (p < 0.001 and 0.05, respectively) compared with non-HCC group. AFP-L3% and p53 levels were significantly (p < 0.001, 0.0001, respectively) higher in HCC than non-HCC patients. AFP-L3% was found significantly correlated with Child-Pugh classification (p < 0.05) and alkaline phosphatase (p < 0.01). While, p53 significantly correlated with age and HCV positivity. ROC curve analysis showed that the highest specificity and sensitivity of the studied parameters are gained at cutoffs of 15%, 120.5 ng/mL, and 0.14 ng/mL for AFP-L3, AFP, and p53; respectively. Combining AFP-L3 and p53 improved sensitivity to 95.4% with a specificity of 85%.
  
  
  CONCLUSIONS
  No significant correlation was found between AFP, AFP-L3%, and p53; however, the simultaneous determination of the three tumor markers yielded a better diagnostic accuracy and sensitivity in the detection of HCCs than each biomarker alone.
authors.forename: Mohamed M
authors.initials: MM
authors.lastname: Abdel-Aziz
authors.forename: Mohamed F
authors.initials: MF
authors.lastname: Elshal
authors.forename: Aymn T
authors.initials: AT
authors.lastname: Abass
authors.forename: Sherif
authors.initials: S
authors.lastname: El-Kafrawy
authors.forename: Sameera
authors.initials: S
authors.lastname: Ezzat
authors.forename: Mohamed
authors.initials: M
authors.lastname: Abdel-Wahab
mesh_terms: D000328:Adult; D000368:Aged; D019540:Area Under Curve; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000473:pathology / Q000821:virology; D016022:Case-Control Studies; D055088:Early Detection of Cancer; D004534:Egypt; D005260:Female; D006509:Hepatitis B / Q000150:complications / Q000821:virology; D006526:Hepatitis C / Q000150:complications / Q000821:virology; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology / Q000821:virology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012372:ROC Curve; D015203:Reproducibility of Results; D016159:Tumor Suppressor Protein p53 / Q000097:blood*; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: C097353:AFP protein, human; C495901:TP53 protein, human; D016159:Tumor Suppressor Protein p53; D000509:alpha-Fetoproteins