1Ola S. M. Ali, 2Maha A. Abo-Shadi and 1Lamiaa
Departments of 1Biochemistry and 2Microbiology
and Immunology, Faculty of Pharmacy (Girls),
This study aims to evaluate the diagnostic power of serum
complements C3 and C4 in early detection of hepatocellular carcinoma (HCC) in
HCV-infected patients with liver cirrhosis (LC). Twenty patients with HCC and
twenty patients with chronic liver diseases (CLD) were recruited for the study.
Twenty healthy non-HCV infected subjects were also included as negative
controls. Serum complements C3 and C4 levels were estimated with nephelometry
while HCV antibody was detected by third generation ELISA kits. Serum samples
were also tested for alpha-fetoprotein by microparticle enzyme immunoassay
kits. Serum levels of complements C3 (124.1 ± 34.4 mg/dl) & C4 (55.9 ± 28.8
mg/dl) in cases of liver cirrhosis without HCC, were lower than in HCC
cirrhotic patients (136.9 ± 39.1 mg/dl) and (62.3 ± 20.7 mg/dl), respectively
(P >0.05). On the other hand, serum levels of C3 & C4 were significantly
higher in HCC group than in controls (101.9 ± 18.7 mg/dl) and (23.8 ± 8.9 mg/dl),
respectively (P< 0.01, P < 0.001). Regarding levels of C3 &C4 in CLD
patients, they were significantly higher than controls (P< 0.05, P <
0.001). The optimal cut-off values selected by Receiver Operating
Characteristic (ROC) curve were 112 mg/dl for C3 and 45 mg/dl for C4. Based on
these data, the positive predictive values, negative predictive values, and the
accuracies for C3 were 59.1%, 55.6%, and 58.1% and for C4 were 65.2%, 75%, and
67.7%, respectively. In conclusion, the combined use of both AFP and C4 at
cut-off 8 ng/ml & 88.1 mg/dl, respectively will result in improving
detection of HCC in HCV-related liver cirrhosis patients.