Assessment of Lens Culinaris Agglutinin-Reactive Fraction Alpha Fetoprotein as an Early Diagnostic Marker for Hepatocellular Carcinoma among Sudanese Patients with Chronic Liver Disease

Abstract

Hepatocellular carcinoma (HCC) is a common complication in patients with chronic viral hepatitis and liver cirrhosis. Detection of HCC at an early stage is critical for a favorable clinical outcome. This study was aimed to determine the usefulness of Lens Culinaris Agglutinin- Reactive Fraction Alpha Fetoprotein (AFP-L3) as an early diagnostic marker for HCC in Sudanese chronic liver disease patients. Across sectional case- control hospital based study was carried out in hepatology referral unit- Ibn Sina Hospital- Khartoum State from March 2011 to January 2012.Venous blood samples (5ml) were collected in plan container from Fifty seven patients; 25 HCC confirmed patients by standard imaging techniques and total Alpha Fetoprotein and 32 Chronic liver disease patients were enrolled in this study. AFP-L3 and Total Alpha Fetoprotein (T.AFP) were measured in serum specimens by immunometric assay. AFP showed the highly increased levels in patients with HCC, while AFP-L3 showed decreased levels. AFP-L3 and T.AFP levels in serum significantly elevated in chronic liver disease patients and HCC patients (AFP-L3: P= 0.006, 0.000 and T.AFP: P= 0.001, 0.000 respectively). In addition, the serum level of AFP-L3 and T.AFP were significantly different with tumor size, number of tumors, and focal liver lesions and age. There was no significant different between male and female patients regarding AFP-L3 (P= 0.261) and T.AFP (P= 0.465). AFP-L3 provides complementary information to T.AFP for an early recognition of malignant liver tumor. These finding encourage us for use the AFP-L3 as adjunct marker for diagnosis of HCC.