Serum amyloid A level as a marker of hepatocellular carcinoma in HCV-induced liver cirrhosis

Document Type : Original Clinical

Authors

1 Clinical and Experimental Internal Medicine Department, Medical Research Institute, Alexandria university.

2 Tropical medicine Department, Alexandria University, Alexandria, Egypt.

3 Department of Epidemiology, High Institute of Public Health, Alexandria University.

4 Internal Medicine Department, Faculty of Medicine ,Alexandria University,Alexandria ,Egypt. Internal medicine Department, Faculty of Medicine ,Beirut Arab University , Beirut,Lebanon.

Abstract

Aim: HCV-induced cirrhosis is recognized as a leading cause of Hepatocellular Carcinoma (HCC) with a high annual incidence in Egypt. The role of serum amyloid A (SAA) has been highlighted in many inflammatory and neoplastic diseases. Accordingly, this study aimed to evaluate the potential of SAA as a biomarker for HCC in patients with HCV-induced cirrhosis and its capacity to predict HCC.
Patients and Methods: A comparative cross-sectional study was conducted on 90 HCV-induced cirrhotic patients. The patients were categorized into established HCC patients on top of HCV-induced cirrhosis (45 patients) and HCV-induced cirrhotic patients without HCC (45 patients). Besides taking history and conducting clinical, laboratory, and radiological examinations, SAA levels were recorded in all patients.
Results: Compared to non-HCC patients, most of the laboratory results were significantly deteriorated in cirrhotic HCC patients. HCC is developed substantially in patients with class C Child Paugh scores (p< 0.001). The mean SAA is elevated considerably in cirrhotic HCC patients than in cirrhotic non-HCC patients (70.38 ± 57.12 vs. 6.84 ± 1.91 ng/mL, respectively). At a cut-off value of >12 ng/mL, the sensitivity and specificity of SAA were 93.33% and 100%, respectively SAA, to diagnose patients with HCC in HCV-induced cirrhosis.
Conclusion: SAA is a highly sensitive and specific marker in diagnosing and predicting HCC development in HCV-cirrhotic patients.

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Footnotes. Ahmed Fathy (Assistant professor of internal medicine, gastroenterology, and hepatology unit), Mohamed Emara (Professor of gastroenterology, hepatology, and infectious diseases), and Amany Mohamed Abdalla (Assistant professor of family medicine) were the peer reviewers. E- Editor: Salem Youssef Mohamed, Osama Ahmed Khalil, Amany Mohammed. Copyright ©. This open-access article is distributed under the Creative Commons Attribution License (CC BY). It may be used, distributed, or reproduced in other forums, provided the original author(s) and the copyright owner(s) are credited. The original publication in this journal must be cited according to accepted academic practice. Disclaimer: The authors' claims in this article are solely their own and do not necessarily represent their affiliated organizations or those of the publisher, the editors, and the reviewers. Any product evaluated in this article or its manufacturer's claim is not guaranteed or endorsed by the publisher. Ethical approval: All procedures involving human participants followed the institutional and national research committee's moral standards, the 1964 Helsinki Declaration, and its later amendments or comparable ethical standards. All authors declare that consent was obtained from the patients (or other approved parties) to publish this study. Study protocol: In adherence to the principles outlined in the Helsinki Declaration, the study protocol was implemented with approval from the institutional review board. Before commencing the research, written consent was obtained from the patients to utilize their clinical information. Data and materials availability: The datasets used or analyzed during the current study are available from the corresponding author upon reasonable request. Competing interests: The authors declare that they have no competing interests. Funding: This study had no funding from any resource. This work was done according to the STROBE guidelines. Authors' contributions M.A. conceived the concept and design of the study. A.H., M.A. tailor data acquisition—M.H. conducted statistical analysis. M.S. analyzed the data and drafted the manuscript. All authors critically revised the manuscript, approved the final version to be published, and agreed to be accountable for all aspects of the work. Acknowledgment: NONE.

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