Diagnostic Value of Serum Glypican 3 in Hepatocellular Carcinoma: A Case Control Study of Patients Seen at the University College Hospital, Ibadan, Nigeria

Abstract

Hepatocellular carcinoma (HCC) is a major health problem which has been increasing in Nigeria with a doubling in the incidence rate in the past 10 years. Current diagnosis of HCC relies on clinical information, liver imaging and measurement of serum alpha-fetoprotein (AFP). The reported sensitivity and specificity of AFP are not sufficient for early diagnosis, and so additional and more sensitive markers are needed. One of such tumor markers is serum Glypican 3 (GPC3). So, this study aimed to determine the frequency of GPC3 in apparently healthy controls and patients with HCC, comparing the diagnostic efficacy of GPC3 to AFP in HCC and to assess the diagnostic accuracy of combined AFP and GPC3 in the diagnosis of HCC.Fifty patients with clinical, radiological and/or histological features of HCC, and fifty apparently healthy controls who were HBsAg and anti-HCV negative and had normal abdominal ultrasonography scan were recruited for the study. Serum estimation of AFP and GPC-3 were done for all the subjects. The sensitivity and specificity of GPC3 was 54 % and 44% respectively based on a receiver operating characteristic(ROC) curve –derived optimum cut-off level >20 ng/ml. The sensitivity and specificity of AFP were 64% and 100% at an ROC derived optimum cut- off level of 20 ng/ml. The area under the receiver operating characteristic curve (AUROC) for AFP was 0.69 and was significantly larger than that of GPC3 which was 0.42(p <0.001). The diagnostic value of GPC3 in our patients with advanced hepatocellular carcinoma is poor in comparison with AFP.

Keywords: Glypican 3, Diagnostic value, Hepatocellular carcinoma, Nigeria

DOI: 10.7176/JHMN/59-06