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ORIGINAL ARTICLE
Year : 2018  |  Volume : 35  |  Issue : 2  |  Page : 235-240

Chromogranin a as a serum marker for hepatocellular carcinoma


1 Professor of Hepatology, Gastroenterology and Infectious Diseases Faculty of Medicine, Benha University, Benha, Egypt
2 Gastroenterology and Infectious Diseases Faculty of Medicine, Benha University, Benha, Egypt
3 Lecturer of Clinical Pathology Faculty of Medicine, Benha University, Benha, Egypt
4 Gastro-Enterology and Hepatolgy Resident Domiat General Hospital, Domiat, Egypt

Correspondence Address:
Dr. Samir H Mosallam
Domiat/Kafr El Bateekh, New Station Square
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/bmfj.bmfj_29_18

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Background Hepatocellular carcinoma (HCC) has an increasing incidence worldwide. The observation of neuroendocrine activity during the clinical course of HCC suggested the use of neuroendocrine serum markers to detect it and elevated serum chromogranin A (CgA) has been reported in patients with HCC. Aim To investigate the clinical utility of serum CgA, as a diagnostic marker of HCC. Patients and methods This study was conducted on 80 patients who were classified into two groups. Group 1: the liver cirrhosis group which included 40 patients diagnosed by clinical settings, laboratory criteria, and radiological methods. Group II: the HCC group which included 40 patients who were diagnosed by two appropriate imaging studies and serum α-fetoprotein (AFP). They were recruited from Hepatology, Gastroenterology, and Infectious Diseases Department, Benha University Hospital. Liver function tests (aspartate aminotransferase, alanine aminotransferase, total bilirubin, and serum albumin) by colorimetric assay, CgA (by enzyme-linked immunosorbent assay), and AFP (by immunometric assay) were estimated. Results CgA levels were significantly higher in group II (HCC patients) when compared with group I (cirrhotic patients) (P<0.0001). A statistically significant positive correlation was detected in the HCC group between CgA versus aspartate aminotransferase, alanine aminotransferase, total bilirubin, direct bilirubin, AFP, Child score, Barcelona-Clinic Liver Cancer Classification, number and size of focal lesions and negative significant correlation versus platelets count and serum albumin (P<0.0001). CgA level shows a best cutoff of 99.95 nmol/l and it showed 90% sensitivity, 90% specificity, 90% positive predictive value, 90% negative predictive value with 95.8% accuracy for the diagnosis of HCC, while when combined with AFP, it had 90% sensitivity, 67.5 specificity, 73.5% positive predictive value, 87.1% negative predictive value with 78.8% accuracy for the diagnosis of HCC. Conclusion CgA represents a useful diagnostic biomarker for HCC.


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