Open AccessJournal Article
Usefulness of alpha-fetoprotein in the diagnosis of hepatocellular carcinoma.
Maurizio Soresi,C Magliarisi,Pietro Campagna,Gaetano Leto,Bonfissuto G,A. Riili,Antonio Carroccio,Roberta Sesti,S. Tripi,Giuseppe Montalto +9 more
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The data confirm that the usefulness of AFP in the diagnosis of HCC of viral etiology is limited, but at this level sensitivity was low, and this cut-off value was more useful in detecting non-viral HCC, because PPV was significantly higher than in viral HCC.Abstract:
With the widespread use of ultrasonography (US) and computerized tomography (CT), the usefulness of alpha-fetoprotein assay in the diagnosis of hepatocellular carcinoma (HCC) has decreased. The aim of our study was to evaluate the best cut-off value for serum alpha-fetoprotein to discriminate between liver cirrhosis (LC) and HCC and the factors influencing levels in a Sicilian population. Three hundred and seventy-two patients with LC and 197 with HCC-associated LC were studied. The etiology was: HCV in 288 cases (77.4%) of LC and 147 cases (75%) of HCC; HBV in 31 cases (8.3%) of LC and 15 cases (7.6%) of HCC; HCV/HBV in 21 cases (5.6%) of LC and 6 cases (3.0%) of HCC; non-viral in 32 cases (8.6%) of LC and 29 cases (15%) of HCC. Hepatic function was estimated by the Child-Pugh's score; the TNM classification was used in HCC. The area under the ROC curve was 0.81 +/- 0.02; the best discriminant cut-off value, calculated as the value of the maximized likelihood ratio, was 30 ng/ml. At this level sensitivity (SE) was 65%, specificity (SP) 89%, positive predictive value (PPV) 74% and negative predictive value (NPV) 79%. When the patients were divided at this cut-off point into two groups according to viral or non-viral etiology, PPV was 70% versus 94%, respectively (p 30 ng/ml correlated positively only with the TNM stage (p < 0.0001). In conclusion, the best cut-off value for serum AFP in our study population was 30 ng/ml, but at this level sensitivity was low. This cut-off value was more useful in detecting non-viral HCC, because PPV was significantly higher than in viral HCC; therefore, our data confirm that the usefulness of AFP in the diagnosis of HCC of viral etiology is limited, being more useful in HCC of non-viral etiology.read more
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Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma.
Masao Omata,Laurentius A. Lesmana,Ryosuke Tateishi,Pei-Jer Chen,Shi-Ming Lin,Haruhiko Yoshida,Masatoshi Kudo,Jeong Min Lee,Byung Ihn Choi,Ronnie T.P. Poon,Shuichiro Shiina,Ann-Lii Cheng,Ji Dong Jia,Shuntaro Obi,Kwang Hyub Han,Wasim Jafri,Pierce K. H. Chow,Seng Gee Lim,Yogesh Chawla,Unggul Budihusodo,Rino Alvani Gani,C. Rinaldi A. Lesmana,Terawan Agus Putranto,Yun Fan Liaw,Shiv Kumar Sarin +24 more
TL;DR: Recommendations on the management of hepatocellular carcinoma were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.
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Serum tumor markers for detection of hepatocellular carcinoma.
TL;DR: Serum alpha fetoprotein mRNA has been shown to correlate with the metastasis and recurrence of HCC, and it may be the most useful marker to prefigure the prognosis.
Journal ArticleDOI
Gene Expression Profiling Reveals Potential Biomarkers of Human Hepatocellular Carcinoma
Hu-Liang Jia,Qing-Hai Ye,Lun-Xiu Qin,Anuradha Budhu,Marshonna Forgues,Yi Chen,Yinkun Liu,Hui-Chuan Sun,Lu Wang,Hong-Zhou Lu,Fang Shen,Zhao-You Tang,Xin Wei Wang +12 more
TL;DR: It is suggested that a diagnostic signature approach using a combined score of these five biomarkers rather than a single marker may improve the prediction accuracy of HCC patients, including those with normal serum AFP and smaller-sized tumors.
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Diagnosing and monitoring hepatocellular carcinoma with alpha-fetoprotein: new aspects and applications.
TL;DR: The aim of this paper is to review the present knowledge on AFP and its related parameters in diagnosing and monitoring HCC and to suggest some of them are recommended as a complementary test but cannot replace serum AFP as the golden standard of diagnostic markers for hepatocellular carcinoma.
Journal ArticleDOI
Present and future possibilities for early diagnosis of hepatocellular carcinoma
TL;DR: This review will focus on other biomarkers that seem to improve HCC diagnosis, such as AFP-L3, des-gamma-carboxyprothrombin, alpha-l-fucosidase, gamma-glutamyl transferase, glypican-3, squamous cell carcinoma antigen, a new generation of immunoglobulin M-immunocomplexes, and very promising gene-expression profiling.