Hepatology and Gastroenterology, National Liver Institute, Menoufia University, Egypt.
Department of Clinical Pathology, National Liver Institute, Menoufia University, Egypt.
Asian Pac J Cancer Prev. 2020 Aug 1;21(8):2259-2264. doi: 10.31557/APJCP.2020.21.8.2259.
Most effective method for reducing mortality from hepatocellular carcinoma (HCC) is early diagnosis. Despite its lack of adequate sensitivity, ultrasound is considered fundamental for HCC screening.
to evaluate urinary neutrophil gelatinase-associated lipocalin (NGAL) as non-invasive marker for HCC diagnosis in Egyptian patients.
One hundred and twenty patients were divided into three groups (40 patients each): patients with chronic viral hepatitis (HCV or HBV), cirrhotic patients and HCC patients and 40 healthy age and gender matched subjects were enrolled as control group. After clinical assessments, urinary NGAL was measured by enzyme-linked immunosorbent assay.
Our results revealed that median level of urinary NGAL was 290, 834, 1090 and 1925 pg/ml in control, chronic hepatitis, cirrhotic and HCC groups respectively among studied groups (p<0.001). Receiver operating characteristics (ROC) analysis showed that urinary NGAL cutoff value of 1255 ng/ml could discriminate between HCC and cirrhosis. The area under curve (AUC) was 0.95 with 90% sensitivity, 87.5% specificity (p-value <0.001). In HCC group, urine NGAL level didn`t show significant correlation with Child Pugh score, MELD score or Barcelona Clinic Liver Cancer (BCLC) stage.
Urinary NGAL could be a simple, non-invasive test for diagnosis of HCC in chronic liver disease patients.
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降低肝细胞癌(HCC)死亡率的最有效方法是早期诊断。尽管超声检查的敏感性不足,但仍被认为是 HCC 筛查的基础。
评估尿中性粒细胞明胶酶相关脂质运载蛋白(NGAL)作为埃及患者 HCC 诊断的非侵入性标志物。
将 120 例患者分为三组(每组 40 例):慢性病毒性肝炎(HCV 或 HBV)患者、肝硬化患者和 HCC 患者,另选 40 例年龄和性别匹配的健康者作为对照组。临床评估后,采用酶联免疫吸附试验检测尿 NGAL。
研究组中,对照组、慢性肝炎组、肝硬化组和 HCC 组的尿 NGAL 中位数分别为 290、834、1090 和 1090 pg/ml(p<0.001)。受试者工作特征(ROC)分析显示,尿 NGAL 截断值为 1255 ng/ml 可区分 HCC 与肝硬化。曲线下面积(AUC)为 0.95,灵敏度为 90%,特异性为 87.5%(p 值<0.001)。在 HCC 组中,尿 NGAL 水平与 Child-Pugh 评分、MELD 评分或巴塞罗那临床肝癌(BCLC)分期均无显著相关性。
尿 NGAL 可作为慢性肝病患者 HCC 诊断的一种简单、非侵入性的检测方法。