title: Serum Alpha-Fetoprotein Has High Specificity for the Early Detection of Hepatocellular Carcinoma After Hepatitis C Virus Eradication in Patients.
abstract: Alpha-fetoprotein (AFP) has not played a large role in the surveillance of hepatocellular carcinoma due to inadequate sensitivity and specificity for active chronic hepatitis or cirrhosis. The aim of this study was to evaluate the diagnostic accuracy of AFP in small hepatocellular carcinomas after hepatitis C virus eradication to determine the optimal cutoff value. We conducted a case-control study of 29 cases and 58 controls, matched for age, gender, and platelet counts. The AFP cutoff was 5 ng/mL in patients after hepatitis C virus eradication and 17 ng/mL in those without hepatitis C virus eradication. The areas under the receiver operating characteristic curve were 0.86 (95% confidence interval, 0.76-0.96) in patients after hepatitis C virus eradication and 0.83 (95% confidence interval, 0.74-0.91) in those without hepatitis C virus eradication. In patients after hepatitis C virus eradication, the sensitivity and specificity of AFP levels were 24.1% and 100%, respectively, using a cutoff value of 17 ng/mL. Using a lower cutoff value of 5 ng/mL, the sensitivity increased to 75.9%, although the specificity decreased to 89.0%. AFP is a specific tumor marker for the diagnosis of hepatocellular carcinoma after hepatitis C virus eradication when using the optimal cutoff value of 5 ng/mL.
authors.affiliation: From the Department of Gastroenterology (TM, RT, MK, RN, NF, MS, KU, KE, HN, YA, YK, KK); Department of Infection Control and Prevention, Graduate School of Medicine, The University of Tokyo (KM); Department of Gastroenterology, Juntendo University, Tokyo, Japan (SS).
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Minami
authors.forename: Ryosuke
authors.initials: R
authors.lastname: Tateishi
authors.forename: Masyuko
authors.initials: M
authors.lastname: Kondo
authors.forename: Ryo
authors.initials: R
authors.lastname: Nakagomi
authors.forename: Naoto
authors.initials: N
authors.lastname: Fujiwara
authors.forename: Masaya
authors.initials: M
authors.lastname: Sato
authors.forename: Koji
authors.initials: K
authors.lastname: Uchino
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Enooku
authors.forename: Hayato
authors.initials: H
authors.lastname: Nakagawa
authors.forename: Yoshinari
authors.initials: Y
authors.lastname: Asaoka
authors.forename: Yuji
authors.initials: Y
authors.lastname: Kondo
authors.forename: Kyoji
authors.initials: K
authors.lastname: Moriya
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Shiina
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Koike
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000209:etiology; D016022:Case-Control Studies; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D016174:Hepacivirus; D019698:Hepatitis C, Chronic / Q000150:complications / Q000188:drug therapy; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000209:etiology; D008297:Male; D008875:Middle Aged; D012074:Remission Induction; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D000509:alpha-Fetoproteins