Clinical characteristics among patients with hepatocellular carcinoma according to the serum levels of alpha-fetoprotein and des-y-carboxy prothrombin.
OBJECTIVE
Only limited amounts of data are available at present regarding the clinical differences in cases of hepatocellular carcinoma who have seropositivity or seronegativity for AFP (alpha-fetoprotein) and DCP (des-y-carboxy prothrombin). In the current study we investigated the different clinical variables in patients with hepatocellular carcinoma according to the serum levels of AFP and DCP.


METHODS
Analyses were performed based on 168 consecutive patients with hepatocellular carcinoma observed for 4 years between July 1997 and December 2000 at the Internal Medicine Department, Saga Prefectural Hospital Koseikan. They were retrospectively evaluated for the analysis in the study. They were classified into four groups according to their serum levels of positivity for AFP and DCP as follows: a Negative group; seronegative for both AFP below 20 ng/mL and DCP below 40mAU/mL, an AFP group; seropositive for AFP above 100 ng/mL and seronegative for DCP, a DCP group; seronegative for AFP and seropositive for DCP above 100mAU/mL and an AFP/DCP group; seropositive for both AFP and DCP. Different clinical variables were compared among the four groups.


RESULTS
There were no significant differences among the groups regarding age, viral markers or the presence of underlying cirrhosis. The DCP group and the AFP/DCP group occurred more often in male patients and they also tended to have a higher incidence of large hepatocellular carcinoma measuring 3 cm or more in greatest dimension compared to the Negative group and the AFP group. The AFP/DCP group showed higher incidences of non-solitary hepatocellular carcinoma and larger hepatocellular carcinoma measuring 3 cm or more in greatest dimension, and the presence of portal thrombosis in comparison to the other three groups and also showed a shorter survival.


CONCLUSIONS
Hepatocellular carcinomas seropositive for DCP were predominantly found in male patients, and hepatocellular carcinoma seropositive for both DCP and AFP tended to be initially diagnosed at an advanced stage which resulted in a shorter survival.
Dohmen
Kazufumi
K
Clinical Research Center, National Nagasaki Medical Center, Nagasaki 856-8562, Japan. dohmenk@par.odn.ne.jp
Shigematsu
Hirohisa
H
Irie
Koji
K
Ishibashi
Hiromi
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006801:Humans; D007564:Japan; D008099:Liver / Q000473:pathology; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009360:Neoplastic Cells, Circulating / Q000473:pathology; D011169:Portal Vein / Q000473:pathology; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D011516:Prothrombin; D012189:Retrospective Studies; D012737:Sex Factors; D000509:alpha-Fetoproteins / Q000378:metabolism*
D015415:Biomarkers; D011498:Protein Precursors; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin