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Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Oct 18, 2015; 7(23): 2474-2481
Published online Oct 18, 2015. doi: 10.4254/wjh.v7.i23.2474
Role of biomarkers in the prediction and diagnosis of hepatocellular carcinoma
Mahmoud Khattab, Magdy Fouad, Elham Ahmed
Mahmoud Khattab, Elham Ahmed, Internal Medicine Department, Minia University, Minia 61111, Egypt
Magdy Fouad, Tropical Medicine Department, Minia University, Minia 61111, Egypt
Author contributions: All authors equally contributed to acquiring the data, reviewing the literature, drafting the article, making critical revisions to the manuscript, and approving of the final version of the article to be published.
Conflict-of-interest statement: All authors declare that they have no conflict of interest to be declared.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Mahmoud Khattab, MD, PhD, Professor of Medicine, Head of Liver Unit, Internal Medicine Department, Minia University, Main Road - Shalaby Land, Minia 61111, Egypt. mkhattabmed@hotmail.com
Telephone: +20-2-5197818 Fax: +20-86-2319040
Received: December 1, 2014
Peer-review started: December 2, 2014
First decision: January 12, 2015
Revised: August 24, 2015
Accepted: September 10, 2015
Article in press: September 16, 2015
Published online: October 18, 2015
Core Tip

Core tip: Alpha-fetoprotein (AFP) has been widely used as a reference biomarker to validate the diagnosis of hepatocellular carcinoma (HCC). However, normal physiological-levels of AFP are observed in approximately one third of HCC cases. Furthermore, a number of HCC positive patients have AFP levels less than the threshold value of 400 ng/mL. These factors make an AFP-based diagnosis of HCC far from reliable. However, high diagnostic accuracy indices have been reported when AFP is combined with other biomarkers such as midkine, golgi protein 73, des-γ-carboxyprothrombin, glypican-3, and gamma-glutamyl transferase.