Background: Hepatocellular carcinoma (HCC) is one of the most common primary malignancies worldwide where abnormal production of des-γ-carboxyl prothrombin (DCP) and fibroblast growth factor 19 (FGF19) has been seen.

Aim: Evaluation of the usefulness of DCP and serum fibroblast growth factor 19 for hepatocellular cancer early detection.

Methods: A case control study which was conducted on 105 subjects at Zagazig University Hospitals. Subjects enrolled in the study were divides into 3 groups: group 1: (35) Cases of HCC patients, recently diagnosed by laboratory, ultrasound and triphasic CT, haven't received any treatment, group 2: (35) Cases of chronic liver disease patients, diagnosed by laboratory and ultrasound and group 3: (35) healthy controls. Fibroblast Growth factor 19 and Des-gamma Carboxy Prothrombin were measured in all cases.

Results: Regarding serum FGF-19, DCP, and alfa feto protein, there is a statistically significant difference between the groups under investigation.For HCC detection, ROC analysis showed the best cut off value for FGF-19 was >238.2 pg/ml with area under the curve (AUC) 0.857, sensitivity 82.9%, specificity 80%, positive predictive value (PPV) 67.4%, negative predictive value (NPV) 90.3%, and total accuracy 81%. However, DCP at a cut-off point >31.5 ng/ml had an AUC 0.902, sensitivity 85.7%, specificity 88.6%, PPV 78.9%, NPV 92.5%, and total accuracy 87.6%.

Conclusion: FGF-19, when used in conjunction with traditional markers like AFP and DCP, may enhance the detection of HCC, especially at an early stage, and may have potential clinical utility in HCC diagnosis and monitoring.