title: Value of alpha-fetoprotein and clinical characteristics in patients with liver neoplasm.
abstract: This article aimed to investigate the value of α-fetoprotein (AFP) for the diagnosis of hepatocellular carcinoma (HCC) and to evaluate the relationship between AFP and various clinical variables of HCC comprehensively. A retrospective study of postoperative patients diagnosed with liver neoplasm from two Chinese centers was enrolled in our study.A total of 3050 patients were included. The best cut-off point of AFP for the diagnosis of HCC was 20ng/ml with ideal sensitivity (69.74%), specificity (91.18%), LR (4.12) and YI (0.61). Non-HBV infection patients showed the highest specificity (94.44%) but lowest sensitivity (60.13%). In HBV infection. Patients, HBsAg, HBeAb, and HBcAb positive patients had the highest sensitivity (79.55%) and specificity (58.49%). AFP levels increased significantly in symptomatic patients (p=0.011). Those patients with tumor sizes ≥10cm had much higher serum AFP level compared with smaller tumors ones (p=0.014). AFP levels increased remarkably in patients with vascular invasion (p=0.015). Stepwise logistic regression showed tumor size (≥10cm) was an independent predictor of elevated AFP (OR=2.743, 95%CI: 1.167-6.447, P=0.021). The best discriminating AFP value for the diagnosis of HCC is 20ng/ml; HBsAg, HBeAb and HBcAb positive patients have the optimal sensitivity and specificity; tumor size ≥ 10cm is an independent predictor of elevated AFP.
authors.forename: J B
authors.initials: JB
authors.lastname: Xu
authors.forename: F Z
authors.initials: FZ
authors.lastname: Qi
authors.forename: G
authors.initials: G
authors.lastname: Xu
authors.forename: G F
authors.initials: GF
authors.lastname: Chen
authors.forename: L X
authors.initials: LX
authors.lastname: Qin
authors.forename: J H
authors.initials: JH
authors.lastname: Zhang
mesh_terms: D000328:Adult; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D005260:Female; D006509:Hepatitis B / Q000097:blood; D006512:Hepatitis B Core Antigens / Q000097:blood; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis* / Q000473:pathology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D000509:alpha-Fetoproteins
chemical_list: D014408:Biomarkers, Tumor; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D000509:alpha-Fetoproteins
keywords: hepatocellular carcinoma, alpha-fetoprotein, diagnosis, hepatitis virus B