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Alpha-L-fucosidase as a tumour marker of hepatocellular carcinoma
Mohamed Fawzy Montaser1, Mohamed Amin Sakr, Mohamed Omar Khalifa
1Tropical Medicine Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
Background And Study Aims:
Alphafoetoprotein (AFP) is not secreted in all cases of hepatocellular carcinoma (HCC) and may be normal in as many as 40% of patients with early HCC. Alpha-l-fucosidase (AFU), a lysosomal enzyme present in all mammalian cells, has been proposed as a tumour marker since many studies reported increased AFU serum levels in patients with cirrhosis and HCC. This study aimed at evaluation of the diagnostic value of AFU as a tumour marker of HCC and its prognostic role in follow-up after intervention.
Patients And Methods:
This prospective case-control study was conducted on 80 patients (40 patients with HCC and 40 patients with chronic liver disease (CLD) as diseased controls) in addition to 40 apparently healthy individuals who served as a healthy control group. AFU serum levels in the three groups were measured and compared.
Results:
There was a statistically highly significant elevation (p<0.001) in the median values of serum AFU in the HCC group (0.99-26.59 μmol l(-1) min(-1)) when compared with both the CLD (0.11-4.60 μmol l(-1) min(-1)) and control (0.1-1.2 μmol l(-1) min(-1)) groups. At a cut-off value of 2.3005 μmol l(-1) min(-1), AFU yielded a sensitivity and specificity of 90% and 97.5%, respectively. In HCC patients, AFU dropped significantly after successful intervention and can be used to follow-up therapy in these patients.
Conclusion:
AFU is a promising tumour marker in the diagnosis of HCC. It can be used also to follow up patients after interventional therapies.
