Prognostic Significance of Three Hepatitis Markers (p53 Antibodies, Vascular Endothelial Growth Factors and Alpha Fetoprotein) in Patients with Hepatocellular Carcinoma

Background/Aim: Hepatocellular carcinoma (HCC) is the third most common cause of cancer death in the world. Of patients with HCC, the diagnostic capacity of Alpha Fetoprotein (AFP) depends on its elevation in the serum. Concentration of AFP greater than the upper reference limit indicate the presence of HCC, but values below this level are less useful because they may also occur in chronic liver disease. To improve the sensitivity of HCC detection by AFP, this work was conducted to study serum expression of p53 Antibodies (p53 Abs) and Vascular Endothelial Growth Factors (VEGF) as a biomarkers in combination with AFP in patients with HCC. Methodology: The study included 67 patients with HCC (58 males and 9 females with a mean age of 53.7 years) and 27 patients with liver cirrhosis (23 males and 4 females with a mean age of 42 years). Ten healthy volunteers served as control group. Sera of all cases were examined for p53 Abs and VEGF by Enzyme linked immunosorbent assay (ELISA) and correlate its levels with serum AFP expression. Results: Serum level of p53 Abs was detected in HCC patients (0.54 +/- 23) with a significant elevation (p < 0.0001) than liver cirrhosis (0.26 +/- 0.1) and healthy individuals (0.21 +/- 0.068). The higher percentage of p53 Abs (73.07%) was detected in HCC patients than in liver cirrhosis (7.4%) (p < 0.0001). Serum expression of VEGF was significantly elevated (p < 0.0001) in HCC patients and in cirrhotic patients than healthy individuals (0.52 +/- 0.25, 0.55 +/- 0.25 vs 0.17 +/- 0.034) while there was no significant difference in VEGF between HCC and cirrhotic patients (p > 0.05). There was no association between either p53 Abs or VEGF and AFP concentrations. However, a greater incidence of VEGF and accumulation of p53 Abs expression was detected in positive cases for AFP where VEGF was detected in 85.3% and p53 Abs was detected in 83.3% of positive cases for AFP. Also, p53 Abs positive patients showed a significant high serum level of VEGF; so both can be used in association for screening of patients with HCC. Conclusion: It could be concluded that p53 Abs can be considered as an additional tumor marker to increase the diagnostic potential of AFP in HCC patients and VEGF may offer a novel diagnostic value for HCC.