ALPHA FETOPROTEIN SERUM LEVELS INFLUENCE BY HBsAg AND ANTI HCV FOR HEPATOCELLULAR CARCINOMA DIAGNOSIS WITH CHRONIC LIVER DISEASE PATIENTS

Virological status was not found to affect the efficacy of (AFP) α-fetoprotein as a marker of hepatocellular carcinoma in patients with chronic liver disease. Objective: To know the influence of serum of serum a-fetoprotein for Hepatocellular carcinoma diagnosis. Place and Duration: The study was performed in the Gastroenterology and Hepatology Department of Nishter Hospital Multan for the period of one year from January 2016 to January 2017. Methods: One hundred and seventy HCC patients and 170 CLD patients were included in the study in a matched case control study for age, gender, HBsAg / anti-HCV, CLD status, specificity, Sensitivity, negative (NPV) and positive (PPV predictive values were calculated. NPV and PPV were assessed for 3 HCC additional prevalences (6, 11 and 20%). Results: The best discriminant AFP level was 17 ng / ml. A 21 ng / ml value (above for HCC should be investigated) had an sensitivity equivalent to 62.0% versus 60.0% and 89.4% versus 89.6%specificity. 20 ng / ml PPV was 85.0%, but the tumor fell to 26.1% with a incidence of 5%. 70% NPV and increased to 98.07% with a incidence of 5%. In different PPV groups of patients who are infected vary from 81.0% to 91.0%, with a prevalence of 5% to 16.9 ± 35.0%. In uninfected patients, 100% PPV with any HCC incidence. NPV vary from 58.90% to 72.90%, with a prevalence of 5% upto 97.0 ± 97.99%. Conclusions: In patients with CLD, monitoring of AFP does not involve many HCCs, and malignancy increases possibility in most of the patients. Its beneficial and is not greatly effected by the CLD-responsible infectious disease. Elevation of AFP is a sign of HCC in uninfected patients.