Predictive Markers for Hepatocellular Carcinoma Development in Patients with Chronic Hepatitis C Virus Genotype4a
Journal Title: Middle East Journal of Cancer - Year 2018, Vol 9, Issue 4
Abstract
Background: Egypt has the highest prevalence of hepatitis C virus worldwide. Monitoring hepatitis C-infected patients for hepatocellular carcinoma development is an important clinical issue to diagnose these patients during the potentially curable early-stage of disease. This study aims to evaluate the role of N-terminal procollagen III, matrix metalloproteinase- 2, tissue inhibitor of matrix metalloproteinase-1, alpha-fetoprotein, and conventional liver function tests as predictors of hepatocellular carcinoma development upon long-term followup of non-responding hepatitis C virus patients. Methods: The study included 850 treatment-naïve hepatitis C virus genotype 4a adult patients; after treatment, 360 achieved sustained viral response while 490 did not. Nonresponding patients had a 5-year rate for hepatocarcinogenesis of 8.4% and a 10-year rate of 27.5%. N-terminal procollagen III, matrix metalloproteinase-2, tissue inhibitor of matrix metalloproteinase-1, alpha-fetoprotein, and conventional liver function tests were evaluated in all patients before and after treatment, and after hepatocellular carcinoma development. The study also included a group of 50 hepatocellular carcinoma patients who were negative for hepatitis C and hepatitis B viruses, and a group of 50 healthy subjects as controls. Results: The non-responders had significantly higher age, stage, grade, viral load, alanine aminotransferase, and aspartate aminotransferase than responders. Also N-terminal procollagen III, matrix metalloproteinase-2, tissue inhibitor of matrix metalloproteinase-1, and alphafetoprotein were significantly higher in non-responders; after treatment they decreased in responders. In non-responders they remained higher than the control. The most significant risk factors for hepatocellular carcinoma development in non-responding hepatitis C virus patients were male gender and increased age, stage, grade, aspartate aminotransferase, Nterminal procollagen III, and tissue inhibitor of matrix metalloproteinase-1. Patients with viral-hepatocellular carcinoma were of significantly lower age, higher grade, stage, γ-glutamyltransferase, N-terminal procollagen III, and matrix metalloproteinase-2 than non-viral hepatocellular carcinoma patients. Percent positive N-terminal procollagen III, tissue inhibitor of matrix metalloproteinase-1, and alpha-fetoprotein were significantly higher in viral hepatocellular carcinoma patients. Conclusion: Data suggest that high N-terminal procollagen III and tissue inhibitor of matrix metalloproteinase-1levels after treatment might be particularly important as markers of hepatitis C virus-non-responding patients who are at higher risk of developing hepatocellular carcinoma, especially in older males with high stage and grade liver disease. However, studies of larger scale are needed to verify this suggestion.
Authors and Affiliations
Ebtsam R. Zaher, Abeer Abdel Rahim Ghazal, Wael A. Ellabban, Mona El-Deeb, Lamyaa Al-Ghaleed
Keywords
Related Articles
- EP ID EP658147
- DOI -
- Views 73
- Downloads 0
Global Inequalities in Cervical Cancer Incidence and Mortality
Objective: Cervical cancer (CC) is the third most common cancer in women after breast and colorectal cancers and is one of the leading causes of cancer death among women in the world. The aim this study is associations o...
Non-Hodgkin’s Lymphoma Mimicking a Locally Advanced Renal Mass: A Case Report
Renal masses can be categorized as benign and malignant lesions. Among the renal malignancies, renal cell carcinoma is the most common malignancy. However, other rare malignant lesions should be considered in differentia...
Effect of Implementing Domestic Truth-telling Protocol on Stress, Anxiety, and Depression in Cancer Patients
Background: The present study was conducted to investigate the effect of implementing domestic truth-telling protocol on stress, anxiety, and depression in cancer patients. Method: In this study, a semi-experimental desi...
Assessment of Elevated Serum Tumor Markers Carcinoembryonic Antigen (CEA) and Cancer Antigen 15-3 (CA15-3) among Patients with Different Subtypes of Metastatic Breast Cancer
Background: Cancer antigen 15-3 and carcinoembryonic antigen are used in clinical and laboratory diagnosis of metastatic breast cancer. Previous studies have noted conflicting results about the association between carcin...
Adherence to a Standardized Order Form for Gastric Cancer in a Referral Chemotherapy Teaching Hospital, Mashhad, Iran
Background: Standardized forms for prescription and medication administration are one solution to reduce medication errors in the chemotherapy process. Gastric cancer is the most common cancer in Iran. In this study, we...