Expression pattern analysis of hepatocellular carcinoma tumor markers in viral hepatitis B and C patients undergoing liver transplantation and resection.
BACKGROUND
This study was conducted to compare the expression patterns of serum alpha-fetoprotein (AFP) and proteins induced by vitamin K absence or antagonist-II (PIVKA-II) in hepatocellular carcinoma (HCC) patients undergoing liver transplantation (LT) and resection at a high-volume single institution.


METHODS
First, 663 liver transplant recipients with HCC were selected. They were divided into hepatitis B virus (HBV) (n = 628) and hepatitis C virus (HCV) groups (n = 35). Their medical records were retrospectively reviewed. Second, another cohort of 2709 patients who underwent HCC resection included 2258 HBV, 143 HCV, and 308 non-HBV non-HCV (NBNC) patients.


RESULTS
In the transplantation group, pretransplantation AFP level >20 ng/mL was observed in 42.5% of HBV patients and 60% of HCV patients (P = .042). PIVKA-II level >40 mAU/mL was observed in 30.6% of HBV patients and 42.9% of HCV patients (P = .127). In the resection group, a preoperative AFP level >20 ng/mL was observed in 51.7% of HBV patients and 43.3% of HCV patients (P = .052). PIVKA-II level >40 mAU/mL was observed in 59.7% of HBV patients and 56.6% of HCV patients (P = .47). Preoperative AFP level >20 ng/mL and PIVKA-II level >40 mAU/mL were observed in 35.7% and 61% of NBNC patients, respectively. Receiver-operator characteristic curve analyses revealed that the expression pattern of PIVKA-II in patients with elevated AFP level was not predictable and vice versa, regardless of background liver diseases.


CONCLUSIONS
This study indicates that serum AFP and PIVKA-II may be expressed variably regardless of the types of background liver disease. Further large-volume multicenter studies are needed to evaluate the possibility of the etiology-dependent expression of tumor markers.
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
T Y
TY
Ha
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. Electronic address: shwang@amc.seoul.kr.
S
S
Hwang
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
K H
KH
Kim
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Y J
YJ
Lee
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
C S
CS
Ahn
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
D B
DB
Moon
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
G W
GW
Song
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
K M
KM
Park
Asan Institute for Life Sciences, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
N
N
Kim
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
S G
SG
Lee
D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000150:complications / Q000601:surgery; D005260:Female; D006509:Hepatitis B / Q000150:complications*; D006526:Hepatitis C / Q000150:complications*; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000150:complications / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged
D014408:Biomarkers, Tumor