Thesis (Ph.D.) - Cairo University - Faculty of Medicine - Department of Medical Biochemistry

We prospectively collected 50 control subjects (group I), 70 HCV patients (group II) and 100 HCC patients (group III) from HCC multidisciplinary clinic (Kasr El- Eini Hospital, Cairo University, Egypt). AFP was measures as proteinby ELISA. AFP and GP73 gene expression were assessed by quantitative reverse transcriptase-polymerase chain reaction (qRT-PCR).Also, AFP- L3 and GP73 serum levels were measured by Western blot technique. Patients' life survivals were calculated. Results: mRNA expression of AFPand GP73 genes in HCC patients [(2.01+0.87) and (4.32+1.56)] were significantly higher than control group [(0.15+0.02) and (0.25+0.03)]& HCV group [(0.86+0.47) and (1.50+0.73)].Protein levels of AFP-L3 and GP73in HCC patients[(11.56+3.85) and (21.75+7.12)], were significantly higher than control group [(0.80+0.36) and (1.40+0.59)] and HCV group [(2.62+1.33) and (7.60+2.90)]. Univariate analysis revealed that up- regulated AFP and GP73 gene expression and AFP-L3 and GP73 protein levels were significant prognostic factors for HCC (p < 0.001). Besides, number of focal lesion and focal lesion size were significant prognostic factors for HCC. Concerning multivariate analysis, up-regulated AFP gene expression and AFP-L3 and GP73 protein levels were significant prognostic factors for HCC (p=0.039,p<0.001, and p=0.039 XI respectively).In addition, focal lesion size (p<0.001) was significantly prognostic factor for HCC. ROC curve comparing AFP, AFP-L3 andGP73 protein levels, showed that GP73 had the highest sensitivity (100%),and followed by AFP-L3 (94.7) and finally AFP with the lowest sensitivity (71.1%). Conclusions: GP73 and AFP-L3 are more sensitive markers than AFP for early detection of HCC patients. Also, both proved to be essential prognostic factors in univariate and multivariate analyses. Key words: Alpha fetoprotein -L3, Golgi protein 73, HCC, HCV

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