Evaluation of tumor markers for the detection of hepatocellular carcinoma in Yangon General Hospital, Myanmar.

Levels of alpha-fetoprotein (AFP), its glycoforms AFP-L3 and AFP-P4, and proteins induced by vitamin K absence or antagonist-II (PIVKA-II) were determined in sera obtained from patients in Yangon General Hospital (20 with hepatocellular carcinoma (HCC), 29 with chronic liver diseases, including 3 with chronic hepatitis and 26 with cirrhosis of the liver, and 9 with other hepatobiliary diseases). Forty-five percent of the patients with HCC had serum AFP levels above 10,000 ng/ml, indicating that nearly half of the HCC patients were at an advanced stage of the disease. Thus, the AFP sensitivity was as high as 70% with 100% specificity for a cutoff level of 200 ng/ml. The sensitivity of AFP-L3 was 75% and a specificity 90% for a cutoff level of 15%. AFP-P4 showed a higher sensitivity of 80% and a similar specificity of 86% for a cutoff level of 12%. Combined evaluation of AFP-L3 and/or AFP-P4 increased the sensitivity to 90% with the same specificity of 86%, indicating that AFP-L3 and AFP-P4 are useful as adjuncts for diagnosis of HCC in the present population. PIVKA-II had a high sensitivity of 90%, although the specificity was lower than 45%, probably due to the low cutoff level, as some cholestatic patients were included in the control group.</p

A Rare Super-Unstable Hemoglobin Variant, Hb Monroe [β30(B12)Arg→Thr], Found in Two Myanmar Children

During the making of a precise molecular diagnosis of blood from transfusion dependent anemic patients in the Union of Myanmar by the PCR-sequencing technique, we encountered two Myanmar children (My-194 and My-201) with a rare abnormal hemoglobin, Hb Monroe [β30(B12)Arg→Thr], which causes β^0-thalassemia due to missplicing in the course of mRNA processing. One of the children, My-194, was a compound heterozygote for Hb Monroe and a thalassemia mutation of βIVS I-5 G→C, who had a condition of severeβ^+-thalassemia resembling a β^0-thalassemia, while the other, My-201, a homozygote for Hb Monroe. However, Hb analyses of My-194 with IEF and DEAE-HPLC revealed a normal pattern, suggesting that it may be due to blood transfusion. Hb analyses of My-201 showed the presence of Hb A to be about 0%, with Hb F being the main Hb component, suggesting that in this case Hb F instead of Hb A may be produced as the main Hb