title: Frequency of elevated biomarkers in patients with cryptogenic hepatocellular carcinoma.
abstract: BACKGROUND
  The incidence of hepatocellular carcinoma (HCC) continues to increase in Japan, but the clinical characteristics of Japanese patients with HCC have not been well described. The aim of this study was to determine the frequencies and utilities of elevated a-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) levels as biomarkers in cryptogenic HCC.
  
  
  METHODS
  A total of 2638 patients with HCC diagnosed between 1999 and 2010 in the Nagasaki Association Study of Liver (NASLD) were recruited for this study. The cause of HCC was categorized into 4 groups; HCC-B, HCC-C, HCC-BC, and HCC-nonBC. The significance of factors was examined for HCC-nonBC using logistic regression analysis in all patients.
  
  
  RESULTS
  Multivariate analysis identified age, sex, BMI, alcohol consumption, platelet count, AST, ALT, AFP, DCP, and TNM stage as independent and significant risk factors for HCC-nonBC. According to TNM stage, the median AFP levels in HCC-nonBC with TNM stages I, II, and III were significantly lower than in either HCC-B or HCC-C. In TNM stage IV, the median AFP level in HCC-nonBC was significantly lower than in either HCC-B or HCC-BC. The median DCP levels in HCC-nonBC with TNM stages I and II were significantly higher than those in either HCC-B or HCC-C. In TNM stage III, the median DCP level in HCC-nonBC was significantly higher than that in HCC-C.
  
  
  CONCLUSIONS
  DCP was more sensitive than AFP for the diagnosis of early stage cryptogenic HCC. DCP should be used as the main serum test for cryptogenic HCC detection.
authors.affiliation: Department of Gastroenterology and Hepatology, Graduate School of Biomedical Sciences Nagasaki University, Nagasaki, Japan.
authors.forename: Naota
authors.initials: N
authors.lastname: Taura
authors.forename: Tatsuki
authors.initials: T
authors.lastname: Ichikawa
authors.forename: Hisamitsu
authors.initials: H
authors.lastname: Miyaaki
authors.forename: Eisuke
authors.initials: E
authors.lastname: Ozawa
authors.forename: Takuya
authors.initials: T
authors.lastname: Tsutsumi
authors.forename: Shotaro
authors.initials: S
authors.lastname: Tsuruta
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kato
authors.forename: Takashi
authors.initials: T
authors.lastname: Goto
authors.forename: Noboru
authors.initials: N
authors.lastname: Kinoshita
authors.forename: Masanori
authors.initials: M
authors.lastname: Fukushima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kato
authors.forename: Kazuyuki
authors.initials: K
authors.lastname: Ohata
authors.forename: Kazuo
authors.initials: K
authors.lastname: Ohba
authors.forename: Junichi
authors.initials: J
authors.lastname: Masuda
authors.forename: Keisuke
authors.initials: K
authors.lastname: Hamasaki
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yatsuhashi
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nakao
mesh_terms: D000367:Age Factors; D000428:Alcohol Drinking; D015415:Biomarkers / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D001774:Blood Chemical Analysis; D015992:Body Mass Index; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000453:epidemiology* / Q000209:etiology; D004797:Enzyme-Linked Immunosorbent Assay; D006801:Humans; D015994:Incidence; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood* / Q000453:epidemiology* / Q000209:etiology; D016015:Logistic Models; D011498:Protein Precursors / Q000097:blood; D011516:Prothrombin; D012737:Sex Factors; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D015415:Biomarkers; D014408:Biomarkers, Tumor; D011498:Protein Precursors; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin