Diagnostic significance of plasma osteopontin in hepatitis C virus-related hepatocellular carcinoma.

BACKGROUND AND AIM: Outcome of hepatocellular carcinoma (HCC) depends mainly on its early diagnosis. The performance of traditional biomarkers is not satisfactory. Osteopontin (OPN) is of potential importance. This study aim to assess the diagnostic value of plasma OPN compared with alpha-fetoprotein (AFP) for the diagnosis of HCV- related HCC. METHODS: We recruited 113 HCC patients compared with 120 matched cirrhotic patients and 120 Controls. The plasma level of OPN and serum AFP for all participants were assessed. RESULTS: The median plasma OPN level was significantly higher in the HCC group than in the cirrhotic patient group or in the normal control group (p-value < 0.001), while OPN levels were not differed significantly in correlation with the degree of liver function deterioration in terms of advanced Child-Pugh class (p-value < 0.9). The diagnostic efficacy of OPN were superior to AFP in terms of AUC, sensitivity, specificity, PPV and NPV either in diagnosis of early or late stages of HCC (0.88 vs. 0.56; P = 0.0001, 0.991vs. 0.899; p = 0.01; respectively). CONCLUSION: Plasma OPN level is a potential diagnostic marker for HCC, especially among high-risk group of patients. These values extend beyond the traditional tumor biomarkers as AFP, as it possesses good prognostic value.

24-hour creatinine clearance reliability for estimation of glomerular filtration rate in different stages of chronic kidney disease.

Glomerular Filtration Rate (GFR) is considered the best overall index of renal function currently used. Measurement of 24 hours urine/plasma creatinine ratio (UV/P) is usually used for estimation of GFR. However little is known about its accuracy in different stages of Chronic Kidney Disease (CKD) aim: is to evaluate performance of UV/P in classification of CKD by comparing it with isotopic GFR (iGFR). 136 patients with CKD were enrolled in this study 80 (59%) were males, 48 (35%) were diabetics. Mean age 46 +/- 13. Creatinine Clearance (Cr.Cl) estimated by UV/P and Cockroft-Gault (CG) was done for all patients, iGFR was the reference value. Accuracy of UV/P was 10%, 31%, 49% within +/- 10%, +/- 30%, +/- 50% error respectively, r(2) = 0.44. CG gave a better performance even when we restrict our analysis to diabetics only, the accuracy of CG was 19%, 47%, 72% in +/- 10%, +/- 30% and +/- 50% errors respectively, r(2) = 0.63. Both equations gave poor classification of CKD. In conclusion, UV/P has poor accuracy in estimation of GFR, The accuracy worsened as kidney disease becomes more severe. We conclude 24 hours CrCl. is not good substitute for measurement of GFR in patients with CKD.