Study of serum vascular endothelial growth factor versus alpha fetoprotein in hcv cirrhotic patients with hepatocellular carcinoma (HCC) before and after therapeutic intervention

Introduction: Hepatocellular carcinoma (HCC) is one of the most common and lethal cancers in the world. More than one million cases of HCC occur in the world each year (Jain et al., 2010). Clearly, the available screening methods are inadequate for early detection and follow up of HCC, so there is need for other markers have to high sensitivity in early diagnosis of HCC as well as the specificity in differentiation between HCC and benign lesions (Padma et al., 2009). Human HCC is a highly angiogenic tumor with several studies showing a strong correlation between tissue VEGF levels and HCC (Semela and Dufour, 2004). The aim of the work: •To study the clinical significance of serum VEGF in hepatitis C cirrhotic patients with HCC as a diagnostic marker before intervention and a prognostic marker after intervention to improve the outcome of HCC diagnosis and treatment • To study the VEGF correlation with hepatocellular carcinoma in hepatitis C cirrhotic patients as a simple non invasive tool Patients and Methods: This study was carried on 80 subjects at the Internal Medicine Department of Ain Shams University Hospitals. classified into 3 groups: Group I was 40 patients with hepatocellular carcinoma and liver cirrhosis, subclassified into Group 1A: Included 20 patients with HCC had been subjected to Radiofrequency ablation Group 1B: Included 20 patients with HCC had been subjected to Transarterial chemo-embolization, Group II was 20 patients with liver cirrhosis only without HCC, Group III was 20 healthy subjects served as control group. HCV related liver cirrhosis and HCC diagnosis were confirmed based on clinical, laboratory and radiological data in addition to serum alpha-fetoprotein (AFP) and Measurment of serum vascular endothelial growth factor (VEGF) Results: The sensitivity and specificity of VEGF has been shown to vary with the different cutoff values used. According to these results the sensitivity and specificity of VEGF for selective detection of the HCC group over the cirrhotic group were 97.5% and 95% respectively, at a cut-off value of 118pg/ml In addition, the accuracy of VEGF was 96.7%, similar to that of AFP 96.7%. Conclusion: Plasma VEGF is a sensitive and specific serum marker for the diagnosis of HCC, also VEGF may play a prognostic marker in HCC management.