%0 Journal Article %T The Use of Serum Survivin and AFP-L3 and their Combination in Improving Hepatocellular Carcinoma Diagnosis Especially in Patients with Low Serum AFP %J The Medical Journal of Cairo University %I The Clinical Society of Cairo University %Z 0045-3803 %A ANWAR MOHAMED, M.D., MAHMOUD MOAWAD, Ph.D.; %D 2018 %\ 12/01/2018 %V 86 %N December %P 3467-3472 %! The Use of Serum Survivin and AFP-L3 and their Combination in Improving Hepatocellular Carcinoma Diagnosis Especially in Patients with Low Serum AFP %K HCC – Survivin – AFP – AFP-L3 – Tumor markers %R 10.21608/mjcu.2018.60585 %X AbstractBackground: Hepatocellular carcinoma (HCC) is respon-sible for about 4.7% of chronic liver disease in Egypt. Survivin is an essential element in apoptosis inhibition. Survivin is present in fetal and malignant adult tissue and is absent in non malignant tissues. A diagnostic and prognostic HCC marker is the alpha-fetoprotein (AFP) binding to Lens culinaris agglutinin (AFP-L3%) percentage. There is a need for HCC marker that is better than AFP especially in those low AFP.Aim of Study: To detect the role of determination of serum Survivin gene, AFP-L3% and their combination in HCC diagnosis.Subjects and Methods: Fifty HCC patients and 20 healthy control persons were subjected for measurement of serum AFP, survivin gene and AFP-L3%. Reverse transcription-polymerase chain reaction (RT-PCR) was used for detection of serum survivin gene. AFP-L3% was measured by a liquid-phase binding assay on the Wako LiBASys clinical auto analyzer.Results: Serum Survivin gene was positive in 27 (54%) HCC cases and negative in 23 (46%) cases. AFP-L3% was detected in 36 (72%) HCC cases. The combined use of serum servivin gene and AFP-L3% were positive in 43 (86%) of HCC cases. In 22 HCC cases with serum AFP below 200 ng/ml serum servivin gene was detected in 9 (40.9%) cases but AFP-L3% was positive in 13 (59.9%) cases and the combined use of positive serum servivin and AFP-L3 were present in 18 cases (81.18%).Conclusions: The combined use of serum survivin gene and AFP-L3% could have a valuable diagnostic role in HCC especially in those with low AFP. %U https://mjcu.journals.ekb.eg/article_60585_7e8d6c374357b80d87b81272db92292a.pdf