A PERMUTATION SOLUTION TO COMPARE TWOHEPATOCELLULAR CARCINOMA MARKERS

In medical literature, alpha-fetoprotein (AFP) is the most commonly used marker for hepatocellular carcinoma (HCC) diagnosis. Some researches showed that there is over-expression of insulin-like growth factor (IGF)-II in HCC tissue, especially in small HCC. In this background, our study investigates the diagnostic utility of IGF-II in HCC. Serum levels of IGFII and AFP were determined on 96 HCC patients, 102 cirrhotic patients and 30 healthy controls. The application of NPC test, stratified for small and large tumours, allowed us to notice 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 for diagnosis of HCC and, subsequently, for small or large HCC. Determination of jointly used markers significantly increases the diagnostic accuracy and sensitivity, with a high specificity. So IGF-II serum can be considered as a usefultumour marker to be jointly used with AFP, especially for diagnosis of small HCC.