Correlation of Hepatocellular Carcinoma with Different Levels of Alpha-Fetoprotein in Pakistani Population

Objective: To assess pathological, biochemical and clinical parameters in HCC patients with low, normal and high AFP levels. Methodology: This comparative analytical study was conducted in Liver and Gastric Clinic, Holy Family Hospital, Rawalpindi from June 2019-June 2020.Sample size was calculated as 225 by WHO sample size calculator . Non randomized convenient sampling was used. Patients were divided into three groups according to AFP values; <200 ng/ml, 200-400ng/ml and >400 ng/ml. Patients demographic details, medical history, clinical symptoms and signs, biochemical parameters and pathological findings on ultrasonography and CECT were assessed. Data was analyzed by SPSS version 21. Descriptive statistics were calculated for categorical  variable.  p Value less than 0.05 was considered significant. Results: Out of 256 patients, 161 (62.9%) were males and 95 (37.1%) were females.The mean age of patients was 60.5 years ± 10.5. 94.4% of patients with HCC had Hepatitis C. Anorexia, jaundice and abdominal distension, hepatomegaly and splenomegaly were more frequent in patients having high AFP level. Serum bilirubin, tumor size, number of lesions, BCLC staging and other pathological parameters associated with HCC worsens as AFP levels increase. Conclusion: Alpha-fetoprotein levels are significantly associated with clinical and pathological parameters of hepatocellular carcinoma thus can be used as a better diagnostic and prognostic tool