ABSTRACT
BACKGROUND: Hepatocellular carcinoma (HCC) accounts for 8.2% of all cancer-related deaths worldwide. Being a vascular tumor, vascular endothelial growth factor (VEGF) plays a vital role in HCC pathogenesis, growth, and spread. AIM: To determine the accuracy of serum VEGF and VEGF/platelet (PLT) as tumor markers in the early detection of HCC cases in patients with hepatitis C virus (HCV)-related liver cirrhosis. METHODS: We conducted a case-control study with HCV patients from the outpatient and inpatient hepatology clinics. Patients were classified into three groups: (1) HCC group; (2) Cirrhosis group; and (3) HCV without cirrhosis (control group). Patients were clinically evaluated, and blood samples were drawn for the analysis; serum VEGF levels were measured by a specific VEGF human recombinant enzyme-linked immunosorbent assay kit. Data from the three study groups were compared by the one-way analysis of variance or Kruskal-Wallis test. Receivers operating characteristic curves were constructed to determine the optimal cut-off values of alpha fetoprotein (AFP), VEGF, and VEGF/PLT that provided the best diagnostic accuracy. The sensitivity and specificity at the optimal cut-off value of each biomarker were then calculated. RESULTS: This study included one hundred patients (HCC, cirrhosis, and control groups: n = 40, 30, 30, respectively). HCC patients had significantly higher serum VEGF and VEGF/PLT levels than the non-HCC groups (P = 0.001). Serum VEGF and VEGF/PLT showed significant positive correlations with and HCC tumor size, stage, vascular invasion, and Child-Pugh classification. Moreover, a VEGF cut-off the value of 250 pg/mL provided 80% sensitivity and 81.7% specificity for discriminating HCC patient from non-HCC patients. Similarly, the ratio of VEGF/PLT provided sensitivity and specificity of 77.5% and 80%, respectively which is higher than the accuracy provided by AFP. The combination of AFP, VEGF, and VEGF/PLT increases the accuracy of diagnosing HCC to > 95%. CONCLUSION: In HCV patients, serum VEGF and VEGF/PLT separately or in combination with AFP are reliable biomarkers for early and accurate HCC diagnosis.
ABSTRACT
OBJECTIVE: This study assessed the effect of cellulose sheets fortified with Natamycin-loaded alginate nanoparticles on the growth of toxigenic Aspergillus flavus and aflatoxin production on the superficial layer of Egyptian Romy cheese after 12 weeks of maturation. MATERIALS AND METHODS: Toxigenic A. flavus (GenBank accession No. MT645073) was inoculated into the outer surface of Egyptian Romy cheese (at 5 log CFU/gm) and wrapped with a cellulose sheet fortified with Natamycin-loaded alginate nanoparticles. Unwrapped control contaminated Romy wheels were made as well as non-contaminated wrapped cheese wheels for sensory evaluation. Romy cheese wheels were stored at a temperature similar to commercial methods for 12 weeks. Fungal counts were enumerated during this time, and enzyme-linked immune sorbent assay detected aflatoxin after the 4th week of maturation storage. RESULTS: In cheese samples covered with cellulose sheets containing Natamycin-loaded alginate nanoparticles, the fungal count was reduced by 2 log approximately in contrast to control samples after the 2nd week of storage. However, within the 8th week of storage, the greatest significant reduction (p < 0.05) was seen where fungal growth was hindered entirely to the end of the ripening period. The mean values for taste, color, flavor, and overall acceptability were 4, 4.7, 4.09, and 4.3, respectively. Furthermore, in the treated samples, the total aflatoxin concentration was decreased by 78.6% relative to the untreated control one. CONCLUSION: Using cellulose sheets fortified with Natamycin-loaded alginate nanoparticles in Egyptian Romy cheese wrapping could be an effective way of controlling A. flavus and subsequent aflatoxin production without influencing the typical taste, color, flavor, and overall appearance of traditional Romy cheese.
