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Abstract

BACKGROUND: Hepatocellular carcinoma (HCC) is a primary tumor of theliver, which develops in the setting of chronic liver disease, particularly in patients with chronichepatitis B and C in almost 80% patients. Although there are no specific screening tests fordiagnosis of HCC but alpha-fetoprotein (AFP) and abdominal ultrasound are commonly used.AFP >400 ng/ml is considered diagnostic for HCC. Objective: The objective of study wasto validate the use of alphafetoprotein as screening test for HCC due to chronic HCV. StudyDesign: Observational cross-sectional. Period: March 2014 to August 2016. Setting: AzizBhatti Shaheed Teaching Hospital Gujrat. Materials and Methods: 134 patients aged >35years having liver cirrhosis due to chronic HCV and diagnosed with HCC using biphasic CTscan were included and were followed for 1 year. Serum AFP was divided in 3 categories anda value < 20ng/ml - normal, 20-399 ng/ml - elevated and >400ng/ml - diagnostic of HCC.Liver nodules size and site was noted and divided in 4 categories. Severity of liver diseasewas calculated using Child Pugh Score. Analysis was done using SPSS 20.0. Results: AFP isdiagnostic (>400 ng/ml) in only 29.9% of patients with sensitivity of 43.3% at cut off value of400 ng/ml and is significantly associated with severity of liver disease. Conclusion: AFP cannotbe used as screening test for HCC in patients with cirrhosis due to chronic HCV. Abdominalultrasound should be used for early detection of HCC due to chronic hepatitis C.