Correlation between the Level of the Tumor Markers with the Stage of Liver Fibrosis in Patients with Chronic Hepatitis and Cirrhosis

Abstract

Background: Many studies in various populations showed the correlation between the level of CA-125, CA15-3, CA19-9 and a.Fetoprotein with the stage of liver fibrosis in chronic hepatitis and cirrhosis. This study was done to evaluate this correlation in Iranian community. Methods: This cross–sectional study was performed on 30 patients with chronic hepatitis that referred for liver biopsy to the gastroenterology department of Isfahan Alzahra hospital from September 2009 to September 2010. Clinical data and routine laboratory tests at the time of liver biopsy were collected, and serum AST, ALT, CA-125, CA15-3, CA19-9 and a.Fetoprotein levels were assayed. Fibrosis staging was assigned according to the HAI (Histological activity index). Data were analyzed by multivariant logistic regression, Spearman’s Ranke Correlation Coefficient, and generalized linear model tests. Findings: Increased CA15-3, CA19-9 and a.Fetoprotein levels were correlated significantly with liver fibrosis staging (P value was 0.008 and 0.004 and 0.038 respectively). We did not find a significant correlation between serum level of CA125 and liver fibrosis staging (P = 0.079). Conclusion: Our findings suggested that elevated CA15-3, CA19-9 and a.Fetoprotein levels were associated with advanced fibrosis. Because of small sample size, we can not recommend these tumor markers as a tool for diagnosis of liver fibrosis staging. But it should be considered that elevation of mentioned markers in patients with advance cirrhosis necessarily does not mean the presence of concomitant malignant tumor.

Keywords

• Alpha-fetoprotein
• Chronic hepatitis
• Liver fibrosis
• CA125
• CA19-9
• CA15-3