Background: Hepatocellular carcinoma (HCC) remains a major contributor to liver-related deaths globally, with a particularly high impact in Egypt, where delayed diagnosis hinders optimal treatment. Alpha-fetoprotein (AFP) is commonly used for HCC screening; however, its diagnostic sensitivity and specificity are limited. Serum Epidermal Growth Factor-Like Domain 7 (EGFL7) has emerged as a promising, non-invasive biomarker with the potential to enhance diagnostic accuracy. This study aimed to assess the effectiveness of EGFL7 as a diagnostic tool for HCC in Egyptian patients with cirrhosis.
Methods: This cross-sectional study included 90 participants, divided into two groups: 45 patients with HCC and liver cirrhosis and 45 cirrhotic patients without HCC. AFP and EGFL7 serum levels were measured using enzyme-linked immunosorbent assay (ELISA). Diagnostic accuracy was evaluated using ROC curve analysis, comparing sensitivity, specificity, and cutoff values for both markers.
Results: EGFL7 levels were considerably higher in HCC patients compared to cirrhotic controls (37.03 ± 15.11 ng/ml vs. 6.41 ± 3.59 ng/ml, P-value <0.001). ROC curve revealed that EGFL7 had a sensitivity of 97.78% and a specificity of 93.33% at a cutoff value of 12.65 ng/ml, outperforming AFP, which had a 93.33% sensitivity and 97.78% specificity at a cutoff of 22.4 ng/ml.
Conclusion: EGFL7 demonstrates higher sensitivity and comparable specificity to AFP, suggesting its utility as a superior diagnostic marker for early detection of HCC in cirrhotic patients. Incorporating EGFL7 into screening protocols may enhance early detection and improve patient outcomes.