Markers of Hepatocellular Carcinoma in HCV-Related Cirrhosis: Clinical and Radiological Findings, Laboratory Parameters, and Seromarkers

Background: Hepatocellular carcinoma (HCC) is a leading cause of cancer death, particularly in patients with chronic hepatitis C virus (HCV) and cirrhosis. Early detection is challenging due to overlapping symptoms with non-malignant liver diseases and the limited effectiveness of traditional biomarkers like AFP. Objectives: To identify markers, including interleukin-20 (IL-20), for early detection of HCC in HCV-related liver disease. Patients and Methods: A case-control study with 320 participants divided into four groups: HCC, HCV-related cirrhosis, chronic HCV infection without cirrhosis, and healthy controls. Clinical, laboratory, serological, and radiological assessments were performed, including measurements of serum IL-20 and AFP. Results: HCC and cirrhosis patients had higher IL-20 and AFP levels than those without HCC or cirrhosis. An IL-20 level >15 pg/mL distinguished HCC with 86.7% sensitivity, 80% specificity, and 83.3% accuracy. Radiological findings in HCC included hypoechoic nodules, arterial hypervascularity, and portal vein invasion. IL-20 correlated with liver dysfunction, fibrosis, and radiological features. Conclusion: IL-20, when combined with AFP and clinical/radiological assessment, improves early detection of HCC in HCV-related cirrhosis, thereby enhancing diagnostic accuracy and surveillance.