Serum alpha-fetoprotein may have a significant role in the surveillance of hepatocellular carcinoma in hepatitis B endemic areas.
OBJECTIVE
The role of serum alpha-fetoprotein (AFP) determination in hepatocellular carcinoma (HCC) surveillance is controversial.


METHODS
We reviewed a total of 132 patients (mean age 57.8 ± 9.6, males = 101 (76%); HBsAg positive = 109 (82.6%); cirrhosis = 94 (71.2%)) who were diagnosed with HCC during regular surveillance test with ultrasound (US) and AFP.


RESULTS
The primary mode of tumor detection was US only in 51.5%, US and AFP in 22.0%, AFP only in 19.7%, and incidental in 6.8% of patients. US detected 68.5% of tumor diagnosed at early stage, which was significantly lower than tumor beyond-early stage (85.0%, p = 0.048). AFP doubling (an increase in AFP level more than double from a prior surveillance) was more frequently observed in HBV-related HCC (47.7%) than HCV-related HCC (11.8%, p = 0.009). The AFP increased sensitivity by 19.7% for all patients; 28.0% for HBV-related early stage HCC patients.


CONCLUSIONS
This result suggest that serum AFP measurements may have a significant role in increasing sensitivity in HCC surveillance, especially for detecting early stage HBV-related HCC.
Dong Hyun
DH
Sinn
Jieun
J
Yi
Moon Seok
MS
Choi
Yu Jin
YJ
Kim
Geum-Youn
GY
Gwak
Joon Hyeok
JH
Lee
Kwang Cheol
KC
Koh
Seung Woon
SW
Paik
Byung Chul
BC
Yoo
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000821:virology; D055088:Early Detection of Cancer / Q000379:methods*; D019353:Endemic Diseases; D005260:Female; D006509:Hepatitis B / Q000097:blood / Q000175:diagnosis / Q000453:epidemiology* / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006801:Humans; D033162:Incidental Findings; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000821:virology; D008113:Liver Neoplasms / Q000097:blood* / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000821:virology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D012307:Risk Factors; D014463:Ultrasonography; D015854:Up-Regulation; D000509:alpha-Fetoproteins / Q000032:analysis*
C097353:AFP protein, human; D006514:Hepatitis B Surface Antigens; D000509:alpha-Fetoproteins