title: [Usefulness of serum alpha-fetoprotein (AFP) as a marker for hepatocellular carcinoma (HCC) in hepatitis C virus related cirrhosis: analysis of the factors influencing AFP elevation without HCC development].
abstract: OBJECTIVE
  Serum alpha-fetoprotein (AFP) is frequently used for the diagnosis of hepatocellular carcinoma (HCC). Most available data concerning AFP came from studies of patients with chronic hepatitis B or mixed etiologies. Studies concerning the diagnostic value of AFP for HCV-related liver cirrhosis (LC) are limited. We evaluated the factors influencing AFP elevation in the absence of HCC and analyzed the diagnostic value of serum AFP in HCC surveillance of HCV-related LC patients.
  
  
  METHODS
  We enrolled 55 patients of HCV-related LC with HCC and 62 patients without HCC as a case-control study were analyzed. The sensitivity and specificity were calculated and the clinical and biochemical factors influencing serum AFP levels.
  
  
  RESULTS
  The sensitivities and specificities of serum AFP for the detection of HCC in HCV-related LC were 72.7% and 59.7% for AFP>or=20 ng/mL, and 47.3% and 92.5% for AFP>or=100 ng/mL, respectively. Elevated serum AST was independently associated with elevated serum AFP level in HCV-related LC. In cases of AST<or=2 upper limit of normal (ULN), the specificity of AFP>or=100 ng/mL for the diagnosis of HCC was 100%. However, in case of AST>2 ULN, the specificity was 85.0% for AFP>or=100 ng/mL and 95.0% for AFP>or=200 ng/mL.
  
  
  CONCLUSIONS
  Serum AST levels influence serum AFP level in HCV-related LC. In cases of AST<or=2 ULN, AFP greater than 100 ng/mL highly indicates HCC in HCV-related LC, but not in case of AST>2 ULN.
authors.affiliation: Department of Internal Medicine, College of Medicine, Inje University, Ilsanpaik Hospital, Ilsan-Gu, Goyang, Korea.
authors.forename: Kyung-Ah
authors.initials: KA
authors.lastname: Kim
authors.forename: June Sung
authors.initials: JS
authors.lastname: Lee
authors.forename: Eun Sook
authors.initials: ES
authors.lastname: Jung
authors.forename: Jong Yeon
authors.initials: JY
authors.lastname: Kim
authors.forename: Won Ki
authors.initials: WK
authors.lastname: Bae
authors.forename: Nam-Hoon
authors.initials: NH
authors.lastname: Kim
authors.forename: Young Soo
authors.initials: YS
authors.lastname: Moon
mesh_terms: D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006526:Hepatitis C / Q000150:complications* / Q000276:immunology / Q000821:virology; D006801:Humans; D008103:Liver Cirrhosis / Q000821:virology*; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins