Background The false negative rate of alpha-fetoprotein (AFP) level alone may be as high as 40% for patients with early stage of hepatocellular carcinoma (HCC) and may be elevated in non-malignant chronic liver diseases and other malignancies. Glypican-3 (GPC-3) is a new tumor marker for HCC.
Objective: Evaluation of the role of serum GPC-3 in the early diagnosis of HCC.
Results: There was a highly significant difference between control and HCC group as regard AFP and serum GPC-3. There  was a highly  significant difference between liver cirrhosis and HCC group as regard AFP and serum GPC-3. No significant difference between control and liver cirrhosis groups as regard AFP and GPC-3. AFP showed sensitivity (75%), specificity (63%), positive predictive value (PPV) (62.8%) and negative predictive value (NPV) (69.9%) at cut-off value 195ng/ml for HCC group. Serum GPC-3 showed sensitivity of (87%), specificity of (95%), PPV of (93.8%) and NPV of (91.2%) at cut-off 5.1ng/ml for HCC group. Combined serum GPC-3 and AFP showed sensitivity (85.9%), specificity (88%) PPV (85.4%) and NPV (84.1%) at cut of value 5.1 ng/ml and 195 ng/ml respectively for HCC group.No significant correlation of serum GPC- 3 or AFP to the tumor size, number or vascular invasion in HCC group.
Conclusion:GPC-3 is a promising diagnostic marker with high sensitivity and specificity for HCC than AFP in detection, screening HCC and follow up treatment of HCC.