Combination of Serum Survivin and AFP as a Potential Marker in HCC Associated with Hepatitis C Viral Infection

摘要

Background and Objective: Hepatocellular carcinoma (HCC) has a rising prevalence rate worldwide. This study aims to appraise the serum survivin levels in malignant and nonmalignant chronic liver diseases (CLDs) patients and to elucidate a possible correlation between survivin and the clinico-pathological characteristics of the disease. Materials and Methods: During the period between May, 2016 and April, 2017, 96 chronic HCV patients with or without cirrhosis were included in this study. Persons with focal lesions in Ultrasound (US) and/or serum α-fetoprotein (AFP) level ≥200 ng mLsup?1/sup were investigated via triphasic computed tomography scanning (CT) and/or MRI. The levels of both survivin and AFP proteins in the serum were detected using ELISA. Results: Survivin was undetectable in 111 out of 120 serum samples (92. 5%). The survivin-positive samples (n = 9, median level, 81.46 pg mLsup?1/sup, range, 9.38-223.81 pg mLsup?1/sup) corresponded to 9 HCC patients who have multiple focal lesions. The sensitivity and specificity of survivin for selective detection of the HCC patients over the non-malignant CLD patients (HCV group and LC group) were 85.7 and 72%, respectively, at a cut-off value -26.196 pg mLsup?1/sup. Also, using a combination of both markers improves the sensitivity, specificity, PPV, NPV to be 85.7, 95, 85.7 and 95% respectively. Conclusion: The previous results suggested that serum survivin could be a potential marker for detecting HCC development. Also, the combination between survivin and AFP is effective for increasing specificity for HCC diagnosis.