Search

Introduction and objectives: The heterogenous nature of hepatocellular carcinoma (HCC) motivated this attempt at developing and validating a model based on combined biomarkers for improving early HCC detection. Patients/materials and methods: This study examined 196 patients for an estimation study (104 patients with HCC, 52 with liver cirrhosis and 40 with liver fibrosis) and 122 patients for the validation study (80 patients with HCC, 42 with liver cirrhosis). All patients were positive for hepatitis C virus. Four markers were measured: Midkine and thioredoxin using ELISA, 1-methyladenosine and 1-methylguanosine using a gas chromatography-mass spectrometry (GC-MS). The results were compared with alpha-fetoprotein (AFP). The performance of the model was estimated in BCLC, CLIP and Okuda staging systems of HCC. Results: The model yielded high performance with an area under ROC (AUC) of 0.94 for predicting HCC in patients with liver cirrhosis, compared with AUC of 0.69 for AFP. This model had AUCs of 0.93, 0.94 and 0.94 in patients who had only one single nodule, absent macrovascular invasion and tumor size <2 cm, respectively, compared with AUCs of 0.71, 0.6 and 0.59 for AFP. The model produced AUCs of 0.91 for BCLC (0-A), 0.92 for CLIP (0-1) and 0.94 for Okuda (stage I) compared with AUCs of 0.56, 0.58 and 0.64 for AFP. No significant difference was found between AUC in the estimation and the validation groups. Conclusion: This model may enhance early-stage HCC detection and help to overcome insufficient sensitivity of AFP. [ABSTRACT FROM AUTHOR]

Introduction Percutaneous treatment of simple or hydatid liver cysts is widely used in clinical practice and ethanol is the commonest sclerosant used. Abdominal discomfort and pain commonly occurs after ethanol injection which increase with increased ethanol volume. Purpose To evaluate the safety and efficacy of the combination of tetracycline and ethanol for percutaneous sclerotherapy of either symptomatic simple hepatic cysts or unilocular hepatic hydatid cysts. Patients and methods A total of 34 adult patients with symptomatic simple cyst and 36 unilocular hydatid cysts underwent clinical, laboratory and radiological evaluations followed by diagnostic cyst aspiration. Each was divided into 2 arms. The first arm was treated by ethanol sclerotherapy and the second was treated by combined ethanol and tetracycline sclerotherapy. Results Combined ethanol and tetracycline sclerotherapy was associated with fewer sessions than ethanol sclerotherapy (P = ≤0.001) and higher rate of sustained cyst size reduction on follow up (P = ≤0.001). Also second arm was associated with less pain than alcohol alone due to the beneficial effect of tetracycline. Conclusion: combined ethanol and tetracycline seems to be more effective, non expensive, more sustained action and more comfortable to our patients than single ethanol use. [ABSTRACT FROM AUTHOR]

Our objective in the present study was to observe the change in the serum MMP-1 concentration using ELISA in 129 chronic hepatitis C (CHC) (78 non-cirrhotic and 51 with cirrhotic liver) and 50 healthy controls. The values of MMP-1 concentration increased in patients with CHC according to the stage of liver fibrosis. An area under the ROC curves (AUC) of the MMP-1 was 0.98 for discriminating patients with cirrhotic liver from healthy individuals and was 0.78 for discriminating patients with cirrhotic liver from non cirrhotic patients. The diagnostic potential of MMP-1 for discriminating cirrhosis from healthy individuals was very high with 98% sensitivity and 97% efficiency. MMP-1 detected cirrhosis in CHC with 71% sensitivity and 73% efficiency. In Conclusion, measurement of serum MMP-1 is useful for diagnosing liver cirrhosis in CHC patients.