A non parametric approach for comparison between two hepatocellular carcinoma markers: alpha-fetoprotein (AFP) and insulin-like growth factor II (IGF-II)

Abstract: Alpha-fetoprotein (AFP) is an useful tumor marker for diagnosis of hepatocellular carcinoma (HCC). There is over-expression of insulin-like growth factor (IGF)-II in HCC tissue. This study investigates the diagnostic application of IGF-II in HCC. Serum levels of IGF-II and AFP were determined on 97 HCC patients, 97 cirrhotic patients and 30 healthy controls. By means of NPC test, we noticed that IGF-II and AFP levels in HCC were significantly higher than cirrhotic patients and controls, the IGF-II levels in cirrhotic patients were significantly lower than controls. The optimal cut-off values for diagnosing HCC were determined with ROC curve. The sensitivity, specificity and diagnostic accuracy values for AFP and IGF-II have been estimated. Determination of jointly used markers significantly increases the diagnostic accuracy and sensitivity, with a high specificity. So, IGF-II serum levels can be considered a tumour marker to be jointly used with AFP for diagnosis of small HCC.