title: The effectiveness of serum alpha-fetoprotein level in anti-HCV positive patients for screening hepatocellular carcinoma.
abstract: OBJECTIVE
  In Taiwan, most cases of hepatocellular carcinoma (HCC) are hepatitis B virus (HBV) or hepatitis C virus (HCV) related. The serum alpha-fetoprotein (AFP) level is an important factor in the diagnosis of HCC. There have been many studies discussing the role of AFP in diagnosing HBV-related HCC, but only few concerning HCV-related HCC. In this study, we aimed at analyzing the distribution of AFP levels in anti-HCV positive patients with and without HCC and evaluating the effectiveness of serum AFP levels in screening HCV-related HCC.
  
  
  METHODS
  From 1993-1996, we collected the AFP data of 205 HCC patients retrospectively, who were anti-HCV positive. For comparison, 131 randomized anti-HCV positive patients without evidence of HCC served as the control group. We analyzed the AFP distribution in both groups over the following ranges: < or = 5 ng/ml, > 5-20 ng/ml, > 20-50 ng/ml, > 50-100 ng/ml, > 100-200 ng/ml and > 200-400 ng/ml, and > 400 ng/ml.
  
  
  RESULTS
  The distributions of AFP levels in anti-HCV positive patients with HCC were 13.2%, 21.5%, 11.2%, 4.9%, 4.4%, 7.3%, and 37.6%. The distributions in anti-HCV positive patients without evidence of HCC were 34.3%, 55.0%, 8.4%, 1.5%, 0.8%, 0%, 0%.
  
  
  CONCLUSIONS
  We found the differences in AFP to be statistically significant between anti-HCV positive patients with and without HCC. A serum AFP level of more than 200 ng/ml highly indicates HCC. However, there is a large overlap between these 2 groups. Thus, in anti-HCV positive patients, AFP level is not a good single reference for diagnosis of HCC. Anti-HCV positive patients should be routinely screened for HCC by image studies along with serum AFP level.
authors.affiliation: Department of Internal Medicine, Taichung Veterans General Hospital, Taiwan.
authors.forename: Y C
authors.initials: YC
authors.lastname: Peng
authors.forename: C S
authors.initials: CS
authors.lastname: Chan
authors.forename: G H
authors.initials: GH
authors.lastname: Chen
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D016174:Hepacivirus / Q000276:immunology*; D006526:Hepatitis C / Q000097:blood / Q000276:immunology* / Q000821:virology; D018937:Hepatitis C Antibodies / Q000032:analysis*; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011863:Radioimmunoassay; D012189:Retrospective Studies; D012307:Risk Factors; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D018937:Hepatitis C Antibodies; D000509:alpha-Fetoproteins