Diagnostic value of glypican-3 in patients with alpha fetoprotein negative hepatitis B related hepatocelluar carcinoma

Objective To evaluate the diagnostic value of glypican-3 (GPC3) in patients with alpha fetoprotein(AFP) negative hepatitis B related hepatocellular carcinoma (HCC). Methods The expression of GPC3 in liver tissue(GPC3L)was tested by immunohistochemistry staining from 426 tissues for surgery and 179 needle biopsy tissues of hepatitis B related HCC patients. serum GPC3 (GPC3S) and AFP were also measured. Results GPC3L was easily detected to be expressed in HCC specific cells, and no expression in paracarcinomatous and cirrhotic nodules tissues. It was found GPC3L was positive in 80.0% (341/426) of tissue samples got from surgery. There was no significant difference of the GPC3L expression among HCC differentiation degree (P0.05). GPC3L was positive in 74.9% (134/179) of needle biopsy tissues from HCC patients. The sensitivity of serum AFP≥400 μg/L for diagnosis HCC was 25.4%. The GPC3L expression was detected in 77.4% (328/424) of patients with serum AFP negative and in 81.2% (147/181) of patients with AFP≥400 μg/L. There was no relationship between GPC3L and AFP. The mean of GPC3S in patients with AFP400 μg/L [(12.63±1.63)μg/L] or AFP≥400 μg/L [(20.20±2.11)μg/L] was significantly higher than that in the control group[(1.92±0.32)μg/L],P 0.01. The cut-off value of GPC3S was 3.5 μg/L to determine HCC as a positive. The sensitivity and specificity in all,AFP≥400 μg/L and AFP negative HCC patients were 54.6% and 75.0%, 54.6% and 80.0%, 80.0% and 76.0%, respec-tively. Conclusion GPC3 may be helpful in improving diagnosis of HCC and in differentiating diagnosis between AFP negative HCC and cirrhotic nodules.