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Subject Area

Clinical Pathology

Article Type

Original Study

Abstract

Background Hepatocellular carcinoma (HCC) is the world's sixth and Egypt's fourth most common cancer, representing the third leading cause of cancer-related deaths worldwide. Circulating cell-free DNA is a type of cell-free nucleic acid derived from apoptotic, necrotic, and living eukaryotic cells. It carries genetic information consistent with tumor cells and has potential for molecular diagnosis of tumors. Objectives To evaluate the clinical significance of plasma circulating cell-free DNA integrity (cfDNAi) as a diagnostic biomarker in HCC compared with alpha-fetoprotein (AFP). Patients and methods This case–control study was carried out on 90 participants who were equally classified into three groups: benign liver diseases, HCC groups, and a control group of apparently healthy adults with matched age and sex. Serum AFP and plasma cfDNAi assays were performed for all participants. Results Patients with HCC had lower plasma cfDNAi than those with benign liver diseases (P = 0.002) and apparently healthy individuals (P = 0.001). The combination of cfDNAi and AFP in differentiation between the HCC group and healthy individuals revealed a sensitivity, specificity, accuracy, positive predictive value, and negative predictive value of 97, 100, 98, 100, and 97%, respectively. Conclusion Plasma cfDNAi can be used as a promising biomarker in the diagnosis of HCC where the combination of cfDNAi and AFP improves the diagnostic performance for HCC diagnosis.

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