Background and study aim: The outcome
of patients with hepatocellular carcinoma
(HCC) remains poor because of late
diagnosis. We aimed to evaluate the
performances of serum alpha -1-acid
glycoprotein (AAG) for the diagnosis of
HCC, especially for HCC with low alphafetoprotein
(AFP).
Patients and Methods: Ninety patients
included in this study, 60 had HCC, and
30 (50%) of these were AFP low HCC
(AFP ≤20 ng/mL). The remaining 30 patients
were chronic hepatitis C and cirrhosis
without HCC as control group. Plasma
AAG was analyzed using quantitative
enzyme immunoassay technique.
Results: Serum level of AAG was
significantly elevated in low AFP HCC
group compared with high AFP HCC and
cirrhotic without HCC group, 1307.20 ±
9627 vs (850.82 ± 795.14 and 309.77±
220.17 respectively). Receiver operating
characteristic (ROC) curve showed that
the best cut off for AAG and AFP was
740 μg/ml and 20 ng/mL respectively.
The area under the curve of AAG was
significantly higher than that for AFP (0.95
vs 0.92) respectively. AAG at a cut-off value
of 740 μg/ml provides higher sensitivity
(73.3% vs 62%, respectively) and specificity
(74.0%, and 71%, respectively) in low
AFP HCC than high AFP HCC
Conclusion: The role of AFP in the
diagnosis of HCC is limited; AAG had
better performance in diagnosing HCC
patients with low AFP. So Serum level of
AAG might be used as a potential diagnostic
marker for hepatocellular carcinoma.