diagnostic performance of fibroblast growth factor-19 in hepatocellular carcinoma

Hepatocellular carcinoma (hcc) is one of the most prevalent malignancies and leading causes of cancer-related deaths worldwide. advances in hcc therapy have been significant but their ineffectiveness is often limited due to late diagnosis and poor prognosis. early diagnosis is the key. afp, currently widely accepted as a tumor marker for hcc, has limited sensitivity and specificity. fgf-19, a hormone involved in glucose and lipid metabolism, is now recognized to play a critical role in the development, proliferation, and survival of hcc. the aim of this study was to measure the level and assess the diagnostic performance of fgf-19 in hcc and compare it with afp in the chronic hepatitis population. serum fgf-19 levels of thirty hcc patients, thirty chronic hepatitis patients, and ten healthy controls were measured using elisa. the diagnostic performance of afp against fgf-19 was also assessed. the median fgf-19 levels of control, chronic hepatitis, and hcc patients were 56.8 pg/ml, 53.4 pg/ml, and 221.5 pg/ml (p<0.001), respectively. the area under the curve of fgf-19 was found to be higher than afp (0.920 compared to 0.741). afp performance with a cut-off of 20 ng/ml showed a sensitivity of 63%, specificity of 86%, positive predictive value of 82.6%, negative predictive value of 70%, and total accuracy of 75%. however, the cut-off value for serum fgf-19 through receiver operating characteristic curve analysis was 153.86 pg/ml, yielded a sensitivity of 83.3%, specificity of 83.3%, positive predictive value of 83.3%, negative predictive value of 83.3%, and total accuracy of 83.3%. serum fgf-19 was significantly increased in hcc population. further studies of other malignancies are needed to validate the performance of serum fgf-19.