Diagnostic value of glypican-3 in alpha fetoprotein negative hepatocellular carcinoma patients

Afr Health Sci. 2013 Sep;13(3):703-9. doi: 10.4314/ahs.v13i3.26.

Abstract

Background: The prognosis of patients with hepatocellular carcinoma(HCC) is generally very poor with a 5-year survival rate of less than 15% since most of them are diagnosed clinically at their late stage. However, the differential diagnosis between alpha fetoprotein(AFP) negative HCC and cirrhotic nodules is still difficult.

Objectives: To evaluate the diagnostic value of glypican-3(GPC3) in patients with AFP negative hepatitis B related HCC.

Methods: The liver tissue GPC3 (GPC3L) expression was tested from 426 for surgery and 179 of needle biopsies of hepatitis B related HCC patients using immunohistochemistry staining. Serum GPC3 (GPC3S) and AFP were also measured.

Results: Among surgical HCC samples, 80.0% of GPC3L expression was positive, however, in paracarcinomatous and cirrhotic nodules were negative. In needle biopsy tissues, GPC3L positively expression was in 74.9%. The sensitivity of AFP>400 µg/L was 25.4%. The GPC3S >3.5 µg/L was determined as a positive. The area of ROC curve of GPC3S was 0.68(95% CI 0.56-0.79,P<0.05) in all HCC patients,0.81 (95% CI 0.62 -0. 98, P<0.05) in AFP greater or equal to 400 µg/L and 0.64 (95% CI 0.51-0.77, P=0.051) in AFP negative patients. The GPC3S was positive in 48.8% of patients with AFP negative. No difference was observed between GPC3L/GPC3S and serum AFP.

Conclusions: GPC3 may be helpful in improving diagnosis of HCC and in differentiating diagnosis between AFP negative HCC and cirrhotic nodules.

Keywords: Alpha fetoprotein; Differential diagnosis; Glypican-3; Hepatitis B; Hepatocellular carcinoma.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Biomarkers, Tumor / analysis*
  • Biopsy, Needle
  • Carcinoma, Hepatocellular / chemistry
  • Carcinoma, Hepatocellular / diagnosis*
  • China
  • Diagnosis, Differential
  • Female
  • Glypicans / blood*
  • Hepatitis B / blood
  • Humans
  • Liver Cirrhosis* / blood
  • Liver Neoplasms / chemistry
  • Liver Neoplasms / diagnosis*
  • Male
  • Middle Aged
  • alpha-Fetoproteins / analysis*

Substances

  • Biomarkers, Tumor
  • Glypicans
  • alpha-Fetoproteins