title: Significance of alpha-fetoprotein and des-gamma-carboxy prothrombin in patients with hepatocellular carcinoma undergoing hepatectomy.
abstract: BACKGROUND
  Alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) are well-known tumor markers of hepatocellular carcinoma (HCC). The aims of this study are to calculate the sensitivity/specificity of AFP and DCP measurement for the diagnosis of HCC, measure response rates of the markers following curative-intent resections, determine the correlations between the marker levels and clinicopathological prognostic variables, and determine the correlations between the marker levels before hepatectomy and those at diagnosis of recurrence.
  
  
  METHODS
  A retrospective cohort study of 714 consecutive patients with HCC undergoing hepatectomy was carried out.
  
  
  RESULTS
  The areas under the receiver operating characteristic curves were 0.79 versus 0.91 for AFP and DCP, respectively (P < 0.001). Positive AFP and DCP status became negative at 6 months post surgery in 184/229 (80.3%) and 245/246 (99.6%) patients, respectively (cutoff values being 20 ng/ml for AFP and 40 mAU/ml for DCP; P < 0.0001). No correlation was found between marker levels (rs = 0.23). The level of DCP, but not that of AFP, showed a close correlation with tumor size (rs = 0.51 and 0.19, respectively). They were associated with indices of tumor invasiveness without showing any specific associations. AFP and DCP levels in patients showing recurrence in </=6 months correlated with the levels measured before surgery (rs = 0.78 and 0.49, respectively) but not in those showing recurrence after 2 years (rs = 0.31 and 0.30, respectively).
  
  
  CONCLUSIONS
  DCP is a more accurate, albeit complementary, HCC marker than AFP. While the levels of both markers increased with advancing tumor growth, no specific associations were found. The marker values at recurrence indicated the type of recurrence.
authors: Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division, Artificial Organ and Transplantation Division, University of Tokyo, Tokyo, Japan.
authors: Kentaroh
authors: K
authors: Yamamoto
authors: Hiroshi
authors: H
authors: Imamura
authors: Yutaka
authors: Y
authors: Matsuyama
authors: Kiyoshi
authors: K
authors: Hasegawa
authors: Yoshifumi
authors: Y
authors: Beck
authors: Yasuhiko
authors: Y
authors: Sugawara
authors: Masatoshi
authors: M
authors: Makuuchi
authors: Norihiro
authors: N
authors: Kokudo
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D015331:Cohort Studies; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis*; D009367:Neoplasm Staging; D011379:Prognosis; D011498:Protein Precursors / Q000097:blood*; D011516:Prothrombin; D012372:ROC Curve; D012189:Retrospective Studies; D055815:Young Adult; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D011498:Protein Precursors; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin