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

This study aimed to enhance the diagnostic ability of alpha-fetoprotein (AFP) by its combination with cytokeratin-1 (CK-1) together with nuclear matrix protein-52 (NMP-52) for discriminating patients with HCC from those with liver cirrhosis. One-hundred and twenty patients categorized into two groups [non-malignant liver cirrhosis and HCC] constituted this study. Using Western blot, a single immunoreactive band was shown at 67 and 52 kDa corresponding to CK-1 and NMP-52, respectively. Using ELISA, patients with HCC were associated with higher concentrations of CK-1 and NMP-52 than those without HCC with a significant difference (P<0.0001). The area under receiver-operating characteristic curve (AUC), sensitivity and specificity were 0.83, 75% and 82%, respectively for CK-1 and 0.72, 62% and 70%, respectively for NMP-52 for identifying HCC. HCC-DETECT comprising CK-1 and NMP- 52 together with AFP was then constructed yielding 0.90 AUC, 80% sensitivity and 92% specificity for identifying HCC. The AUC for HCC-DETECT in patients with HCC who had only single tumor, absent vascular invasion, and tumor size less than 5 cm were 0.93, 0.92, and 0.92, respectively. Model values increase with the progression in HCC stages of Child{u2013}Turcotte-Pugh, Okuda and CLIP systems. In conclusion, CK-1 in conjunction with NMP-52 and AFP have a potential role for improving the detection of HCC with a high degree of accuracy

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