Comparison between glypican-3 and alpha-fetoprotein in discrimination of hepatocellular carcinoma from cirrhotic patients

Background: Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer. Liver cirrhosis progression could be a consequence of developing HCC. Although alpha-fetoprotein (AFP) is widely used as, a marker for the detection of HCC, but it has poor sensitivity. Objective: Evaluate the diagnostic power of serum AFP and Glypican-3 (GPC3) as biomarkers of the development of HCC. Subjects and Methods: A total of 182 patients, 110 patients with HCC, and 72 patients with liver cirrhosis were included. AFP and GPC3 were determined using ELISA. The diagnostic power was evaluated using Area under Roc curve (AUC). Results: levels of AFP and GPC3 in sera of HCC patients were higher than in those with liver cirrhosis (p < 0.0001). AFP had Area under curve (AUC) = 0.772 with sensitivity 39.1%, specificity 97.2%, positive predictive value (PPV) 97.7%, negative predictive value (NPV) 34.3% and efficiency 53.4% while GPC3 had AUC=0.841 yielded sensitivity 76.4%, specificity 86.1%, PPV 94.4%, NPV 64.3% and efficiency 78.8%. There was significant weak correlation (r = 0.241; P < 0.001) between AFP and GPC3. Conclusions: GPC3 is a good marker for HCC diagnosis. Therefore, GPC3 may be more useful than AFP in differentiating HCC from cirrhotic patients.