Clinical Utility of Cytokeratin in The Early Detection of Hepatocellular Carcinoma Among Hepatitis C Virus Patients
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Date
2024
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Helwan University
Abstract
Objectives: Hepatocellular carcinoma (HCC) is a primary malignancy of
the liver and a global health problem. It is often diagnosed at advanced stage
where hopeless for effective therapies. Identification of more reliable biomarkers
for early detection of HCC is urgently needed. Cytokeratins are a marker of
hepatic progenitor cells and act as a key player in tumor invasion. Herein, we
sought to develop a novel score based on the combination of cytokeratin 18
(CK18) and cytokeratin 19 (CK19) with routine laboratory tests for accurate
detection of HCC. Material & Methods: Serum CK18, CK 19, α-fetoprotein,
albumin and platelets count were assayed in HCC patients (75), liver cirrhosis
patients (55) and healthy control (20). Areas under receiving operating curve
(AUCs) were calculated and used for construction on novel score. A novel score
named CK-HCC = CK 19 (%)×0.001+ CK18 (%)×0.004 + AFP (U/L)×5.4 -
Platelets count (×109)/L×0.003 – Albumin (g/L)×0.27–36 was developed. CK-
HCC score produces AUC of 0.919 for differentiating patients with HCC from
those with liver cirrhosis with sensitivity and specificity of a cut-off 1.3 (i.e., less
than 1.3 the case is considered cirrhotic, whereas above 1.3 it is considered HCC.
Conclusion: CK-HCC score could replace AFP during screening of HCV patients
and early detection of HCC.
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Keywords
Hepatocellular carcinoma- HCV- Cytokeratins- Diagnosis