Tumour Markers for Hepatocellular Carcinoma
Up to 95% of primary liver cancers are hepatocellular carcinomas (HCCs). Around 80%–90% of HCC cases occur with underlying cirrhosis; however coinfection of HBV/HCV and HBV/HDV significantly increases the risk of HCC by two to six folds. Similarly, alcohol abuse further increases this risk.
Early diagnosis and effective treatment of HCC is associated with increase in survival rates. Unfortunately, clinical symptoms become evident only in the advanced stages; therefore, early detection is vital. Expression levels of tumor markers aid in the early detection of HCC improving survival rates.
Many HCC tumor markers exist, however, most single indicators lack specificity of the tissues and organs, since HCC exhibits variations that are closely associated with the occurrence, development, transfer, effect and prognosis of tumors. So, a combination of tumor markers can improve detection to offer a correct diagnosis of HCC.
Nevertheless, the diagnosis of HCC must include clinical manifestation, iconography detection and histological examination.
The following HCC tumor markers are already in use, and the potential of novel tumor markers are mentioned as follows:
α-Fetoprotein and glycoforms of α-fetoproteins
- α-fetoprotein (AFP) is the most commonly used HCC tumor marker with sensitivity of 41–65% and specificity of 80–94% when the cut-off value is 20 ng/ml. AFP can produce negative or delayed in small size HCC.
- Three novel glycoforms of alpha Feto Protein (AFP-L1, AFP-L2 and AFP-L3) have also been identified. AFP-L3 is expected to be a useful marker for HCC. The sensitivity and specificity of AFP-L3 has been found to be as high as 96.9 and 92%, respectively.