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ORIGINAL ARTICLE
Year : 2019  |  Volume : 3  |  Issue : 3  |  Page : 573-582

Serum level of cluster of differentiation 166 as novel biomarker in hepatocellular carcinoma


1 Clinical Pathology Department, Faculty of Medicine of Girls, Al-Azhar University, Cairo, Egypt
2 Tropical Medicine Department, Faculty of Medicine of Girls, Al-Azhar University, Cairo, Egypt
3 Central Public Health Laboratories, Serology Department, Faculty of Medicine of Girls, Al-Azhar University, Cairo, Egypt

Correspondence Address:
Nessren M.B El-Deen Mohamed
MD of Hepatogastroentrology and Infectious Diseases
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/sjamf.sjamf_30_19

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Background The detection of serum biomarkers associated with hepatocellular carcinoma (HCC) is the most promising approach to improve diagnostic accuracy and to overcome the disadvantages of current diagnostic strategies. The aim of this study was to evaluate the diagnostic value of serum level of cluster of differentiation 166 (CD166) in early detection of patients with HCC. Patients and methods This study was conducted on 90 patients, divided into three groups: group 1 included 30 patients with unstaged HCC; group 2 included 30 patients with HCV-related liver cirrhosis (LC) without HCC, who were subdivided into 2a subgroup (15 patients with compensated liver cirrhosis) and 2b (15 patients with decompensated liver cirrhosis); and group 3 included 30 sex-matched and age-matched apparently healthy individuals as a control group. All patients and control were subjected to detailed history taking and clinical examination, abdominal ultrasonography, and/or computed tomography. Laboratory investigations included complete blood picture, liver function tests, serum viral hepatitis markers, serum urea and creatinine, α-fetoprotein (AFP), antinuclear antibody, and assay of CD166 using enzyme-linked immunosorbent assay. Results CD166 was significantly higher in HCC group, compensated LC patients group, and decompensated LC patient group, when compared with control group (P<0.001), and in decompensated LC (P=0.003) and HCC group (P=0.01) when compared with compensated LC patient group. Receiver operating characteristic curve analysis was applied to assess the diagnostic performance of AFP, CD166, and combined AFP and CD166 in discrimination between LC and healthy control participants. Area under the curve (AUC) of AFP, CD166, and AFP+CD166 showed significant discrimination between LC and control (AUC=0.786, 0.999, and 1, respectively). CD166 and combined AFP+CD166 showed significantly higher AUC when compared with AFP AUC. For discrimination between CLD (compensated and decompensated) and healthy control participants, at the optimum cutoff level of 5.5 ng/ml for AFP, the diagnostic sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were 73.3, 76.7, 75, and 71.9, respectively, and at the optimum cutoff level of 167.5 ng/ml for CD166, the diagnostic sensitivity, specificity, PPV, and NPV were 96.7, 100, 100, and 96.8, respectively. However, at the optimum cutoff level of combined AFP and CD166, the diagnostic sensitivity, specificity, PPV, and NPV were 100, 100, 100, and 100, respectively. Conclusion The combination of CD166 and AFP is a better biomarker for diagnosis of HCC, where the combination showed higher diagnostic sensitivity and specificity than AFP alone.


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