Value of Chromogranin A as a Prognostic Marker in Cirrhotic Patients with HCC before and after Radiofrequency

Abstract Background The majority of HCC cases are undetected until advanced stage owing to lack of symptoms and the absence of sensitive and convenient screening procedures. The overall AFP performance in this field has been inadequate in terms of its poor specificity and sensitivity. Various prior studies found an elevated serum Cg-A concentrations in HCC patients. Radiofrequency ablation (RFA) is the preferred approach for small sized lesion. Therefore, the aim of this study was to highlight the value of determination of CgA serum levels in monitoring patients with cirrhosis for early detection of HCC and its significance as a prognostic marker in patients with very early/early stage of HCC before and after radiofrequency. Subjects and methods The present study enrolled 30 cirrhotic patients with very early/early stage of HCC, 15 cirrhotic patients without HCC, and 15 healthy controls. Serum AFP & Cg-A levels were estimated in all patients before intervention and 1 month after radiofrequency ablation in the HCC group. Results Serum Cg-A was significantly higher in HCC cases compared to healthy subjects and cirrhotic patients (P = 0.001). At a cut off value of 250 (ng/ml), serum Cg-A had a 96.7% sensitivity and a 93.3% specificity for detecting HCC while AFP at 3.736 ng/ml had 93.3% sensitivity and 86.7% specificity. Furthermore, the selected cut-off values to distinguish HCC patients who have better (improved) outcome from those with bad outcome was 375 (ng/ml) with 96.7% sensitivity and 76.7% specificity (for Cg –A) and 17 (ng/ml) with 73.3% sensitivity and 70% specificity (for AFP). Conclusion Cg-A can act as valuable diagnostic as well as prognostic biomarkers for liver cirrhosis and HCC as it was significantly higher in HCC patients than in cirrhotic patients and controls and it had higher sensitivity, specificity than AFP for HCC diagnosis.