Potential Diagnostic Role of Serum Fibroblast Growth Factor-19 in Hepatocellular Carcinoma

Document Type : Research Articles

Authors

1 Clinical Oncology Department, Cairo University, Cairo, Egypt.

2 Hepato-gastroenterology and Endemic Medicine Department, Student’s Hospital, Cairo University, Cairo, Egypt.

3 Clinical and Chemical Pathology, Cairo University, Cairo, Egypt.

4 Internal Medicine Cairo University, Cairo, Egypt.

5 Endemic Medicine and Hepatology, Cairo University, Cairo, Egypt.

Abstract

Introduction: A highly accurate diagnostic method is crucial to reduce mortality and increase hepatocellular carcinoma (HCC) survival. Current biomarkers have limited accuracy, and novel ones are needed. Fibroblast growth factor-19 (FGF-19) is overexpressed in HCC. This study aimed to assess FGF-19 as a potential novel diagnostic biomarker for HCC. Methods: This case-control study involved 114 individuals divided into three equal groups: HCC (n=38), Cirrhosis (n=38), and Control (n=38). HCC biomarkers included alpha-fetoprotein (AFP), Des-γ-carboxy prothrombin (DCP), and FGF-19. Results: The three markers, FGF-19, DCP, and AFP, were significantly different between the three groups, except that DCP was comparable between HCC and Cirrhosis groups (p=1.000). All individuals in the control group had FGF-19 levels below the minimum level in the HCC group. Thus, FGF-19 had 100% sensitivity and specificity in differentiating HCC from healthy controls. FGF-19 can discriminate between HCC and Cirrhosis groups at a 140.8 pg/mL cutoff with sensitivity and specificity of 81.8% and 87.9%, respectively. The sensitivity of FGF-19 was higher than AFP, trending toward statistical significance (p=0.095). Combining FGF-19 with AFP, DCP, or both improved sensitivity but decreased specificity. Conclusion: FGF-19 is a possible noninvasive serum biomarker for HCC. Its combination with AFP or DCP improves the sensitivity for detecting HCC.

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