Significance of Glypican-3 in Early Detection of Hepatocellular Carcinoma in Cirrhotic Patients

  • Ahmed M. Tahon
  • Magdy Z. El-Ghanam
  • Samy Zaky
  • Tarek Mostafa Emran
  • Ali M. Bersy
  • Fathiya El-Raey
  • Elsayed A.Z.
  • Amr M. El Kharsawy
  • Dina Johar
Original Research



Egypt has high incidence of hepatocellular carcinoma (HCC). This is due to wide spread of hepatitis C virus (HCV) infection which is responsible for most of the cases of liver cirrhosis. The major diagnostic techniques for HCC include serum markers and various imaging modalities. Glypican 3 (GPC3) protein is highly expressed in HCC, but not in normal liver tissue. The significance of GPC3 as a predictor or diagnostic tool for human tumors other than HCC is unclear.


To quantitatively assess the role of GPC3 in diagnosis of HCC in comparison to α-fetoprotein (AFP), ultrasonography (US), and computerized tomography (CT).

Patients and Methods

This cross-sectional study enrolled 85 subjects: 40 cirrhotic patients with primary HCC, 30 cirrhotic patients without HCC, and 15 healthy individuals. All patients were recruited from the Gastroenterology and Tropical Departments and outpatient clinics of New Damietta Hospital during the period from November 2010 to August 2012.


GPC3 is positive in some HCC patients with normal levels of AFP. AFP has lower sensitivity (67.5%) compared to higher sensitivity of GPC3 (82.5%), and near specificity (61.2%) to GPC3 (57.8%).

Conclusion and Significance

The combined serum AFP and GPC3 significantly increased the sensitivity of HCC diagnosis. Although GPC3 is better than AFP in diagnosis of HCC, it still lacks the 100% sensitivity and specificity because some patients have negative or normal level of GPC3 (below the cutoff point 1.5 ng/ml) despite being diagnosed by triphasic CT.


α-Fetoprotein Ultrasonography Triphasic CT Glypican-3 Hepatocellular carcinoma Cirrhosis Viral hepatitis 


Authors’ Contributions

All authors contributed to conception, design, data analysis, and writing the manuscript. D.J. provided ENDNOTE X8 software required for the production of this manuscript.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the research committees of Al-Azher University Faculty of Medicine and Al-Azhar University Hospital in New Damietta, Egypt.

Informed Consent

Written consent was obtained from all individual participants.

Supplementary material

12029_2018_95_MOESM1_ESM.doc (230 kb)
ESM 1 (DOC 230 kb)
12029_2018_95_MOESM2_ESM.docx (50 kb)
ESM 2 (DOCX 50.3 kb)


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Clinical Pathology, Faculty of MedicineAl-Azhar UniversityCairoEgypt
  2. 2.Department of Clinical Pathology, Faculty of MedicineAl-Azhar UniversityDamiettaEgypt
  3. 3.Department of Tropical Medicine, Faculty of MedicineAl-Azhar UniversityCairoEgypt
  4. 4.Faculty of SciencesJouf UniversityJoufKingdom of Saudi Arabia
  5. 5.Zoology Department, Faculty of SciencesAl-Azhar UniversityCairoEgypt
  6. 6.Department of Biochemistry and Nutrition, Faculty of Women for Arts, Sciences and EducationAin Shams UniversityCairoEgypt
  7. 7.Department of Physiology and Pathophysiology, Max Rady College of Medicine, Rady Faculty of Health SciencesUniversity of ManitobaWinnipegCanada

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