Evaluation of Fucosylated Haptoglobin as a Diagnostic Biomarker for Hepatocellular Carcinoma in Egypt

Nahla M. Shalably1, Rehab Badawi2, Nehad Hawash2, Sherief Abd-Elsalam2, *, Walaa Elkhalawany2, Amal Abd EI Hameed3, Galal El-Din Alkassas2
1 Kafr-Elzayat Fever Hospital, Kafr-Elzayat, Egypt.
2 Tropical Medicine Department, Faculty of Medicine, Tanta University, Tanta, Egypt.
3 Clinical pathology Department, Faculty of Medicine, Tanta University, Tanta, Egypt.

© 2019 Shalably et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Tropical Medicine Department, Tanta University Hospital, El Geish Street, Tanta, Gharbia Governorate, Egypt; Tel: 00201147773440, ORCID: 0000-0003-4366-2218, Email:



Most Hepatocellular Carcinomas (HCCs) are diagnosed at an advanced stage. Therefore, there is citation-type an urgent need for better methods of detection and surveillance of patients at risk of HCC. Alpha-fetoprotein (AFP) has a suboptimal diagnostic performance for HCC surveillance, so novel and reliable diagnostic biomarkers are required.


The aim of this work is to evaluate fucosylated haptoglobin as a diagnostic biomarker for hepatocellular carcinoma in Egyptian patients.

Materials and Methods:

This case-control study was carried out on 60 patients classified into 3 groups (20 patients on each); group I (HCC group), group II (Cirrhotic group) and group III (Control group). Diagnosis of liver cirrhosis was done by clinical, biochemical and ultrasound (US), whereas the diagnosis of HCC was done by percutaneous biopsy or radiological (by US and triphasic Computerized Tomography (CT) based on the guidelines of the American-Association for the Study of Liver Diseases. HCC stage was clinically defined according to the Barcelona Clinic Liver Cancer (BCLC) staging system. AFP & fucosylated haptoglobin levels were estimated in all groups.


There was a statistically significant positive correlation between serum fucosylated haptoglobin and tumor size in the HCC group. Serum fucosylated haptoglobin (at 116 U/ ml) showed sensitivity 80%, specificity 65%, positive predictive value 53% and negative predictive value 87% with AUC 0.786. Combination of serum fucosylated haptoglobin and serum AFP at (200 ng/ ml) increased sensitivity that reached 95%.


Serum fucosylated haptoglobin may serve as a novel diagnostic biomarker for the detection of HCC with higher sensitivity than AFP.

Keywords: Fucosylated haptoglobin, Alpha-fetoprotein, Biomarker, Cirrhosis, HCC, Egypt.