Evaluation the Role of Lipocalin 2 as a New Non-Invasive Diagnostic Marker for Hepatocellular Carcinoma in Egyptian Cirrhotic Patients

Abstract Background Hepatocellular carcinoma (HCC) represents the sixth most common cancer worldwide. In Egypt, it represents the fourth common cancer. Significant risk factors for hepatocellular carcinoma include viral hepatitis (hepatitis B and hepatitis C), alcoholic liver disease, and non-alcoholic liver steatohepatitis/non-alcoholic fatty liver disease. HCC occurs in 80%-90% of patients with cirrhosis. The annual incidence of HCC in patients with cirrhosis is 2-4%. Aim of the Work The aim of this study is to evaluate the role of lipocalin 2 (LCN 2) as a diagnostic marker in HCC Egyptian patients. Patients and Methods A case-control study in Ain- Shams University Hospital for 6 months period and the study will be conducted on 96 Egyptian patients (32 HCC patients, 32 liver cirrhosis without HCC, 32 normal control persons). Res1ults We found that LCN 2 level ranged from 150 to 380 in HCC group with mean±SD = 292.750±50.940, from 88 to 280 in cirrhotic patients with mean± SD = 129.313±36.605, from 40 to 62 in control group with mean± SD = 53.250± 4.958, being statistically significant higher in HCC group more than both cirrhotic group and control group and in cirrhotic patients more than control group (p-value = 0.001). The results showing sensitivity of 96.87% and specificity 96.87% of LCN 2 as a marker for HCC with accuracy of 98.4%,with cut off 160. The presence of (LCN-2) in blood and urine, in combination with α-Fetoprotein (AFP), is a biomarker of early stages of HCC. LCN 2 is a promising serum tumor marker for HCC diagnosis. Conclusion We concluded from this study that: Serum LCN 2 level was significantly higher in patients with HCC and mildly elevated in patients with liver cirrhosis compared to the control group. So it can be used as a tumor marker for HCC diagnosis. Use of LCN 2 with AFP or possibly other markers will improve the diagnostic field and can help in early detection of HCC in surveillance programms. We need further studies on large number of HCC patients of different etiologies and on metastaic liver tumors to clarify the accuracy and potential diagnostic role of LCN 2 in the future.