title: Alpha-fetoprotein and des-gamma-carboxy-prothrombin at twenty-four weeks after interferon-based therapy predict hepatocellular carcinoma development.
abstract: OBJECTIVE
  To investigate risk factors for development of hepatocellular carcinoma (HCC) in patients with hepatitis C virus-related liver cirrhosis (LC-C).
  
  
  METHODS
  To evaluate the relationship between clinical factors including virological response and the development of HCC in patients with LC-C treated with interferon (IFN) and ribavirin, we conducted a multicenter, retrospective study in 14 hospitals in Japan. All patients had compensated LC-C with clinical or histological data available. HCC was diagnosed by the presence of typical hypervascular characteristics on computed tomography and/or magnetic resonance imaging.
  
  
  RESULTS
  HCC was diagnosis in 50 (21.6%) of 231 LC-C patients during a median observation period of 3.8 years after IFN and ribavirin therapy. Patients who developed HCC were older (P = 0.018) and had higher serum levels of pretreatment alpha-fetoprotein (AFP) (P = 0.038). Multivariate analysis revealed the following independent risk factors for HCC development: history of treatment for HCC [P < 0.001, odds ratio (OR) = 15.27, 95%CI: 4.98-59.51], AFP levels of ≥ 10 ng/mL (P = 0.009, OR = 3.89, 95%CI: 1.38-11.94), and des-γ-carboxy prothrombin (DCP) levels of ≥ 40 mAU/mL at 24 wk after the completion of IFN and ribavirin therapy (P < 0.001, OR = 24.43, 95%CI: 4.11-238.67).
  
  
  CONCLUSIONS
  We suggested that the elevation of AFP and DCP levels at 24 wk after the completion of IFN and ribavirin therapy were strongly associated with the incidence of HCC irrespective of virological response among Japanese LC-C patients.
authors.affiliation: Satoshi Shakado, Shotaro Sakisaka, Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka City, Fukuoka 814-0180, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Shakado
authors.affiliation: Satoshi Shakado, Shotaro Sakisaka, Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka City, Fukuoka 814-0180, Japan.
authors.forename: Shotaro
authors.initials: S
authors.lastname: Sakisaka
authors.affiliation: Satoshi Shakado, Shotaro Sakisaka, Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka City, Fukuoka 814-0180, Japan.
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
authors.affiliation: Satoshi Shakado, Shotaro Sakisaka, Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka City, Fukuoka 814-0180, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Okanoue
authors.affiliation: Satoshi Shakado, Shotaro Sakisaka, Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka City, Fukuoka 814-0180, Japan.
authors.forename: Joji
authors.initials: J
authors.lastname: Toyoda
authors.affiliation: Satoshi Shakado, Shotaro Sakisaka, Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka City, Fukuoka 814-0180, Japan.
authors.forename: Namiki
authors.initials: N
authors.lastname: Izumi
authors.affiliation: Satoshi Shakado, Shotaro Sakisaka, Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka City, Fukuoka 814-0180, Japan.
authors.forename: Akihiro
authors.initials: A
authors.lastname: Matsumoto
authors.affiliation: Satoshi Shakado, Shotaro Sakisaka, Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka City, Fukuoka 814-0180, Japan.
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Takehara
authors.affiliation: Satoshi Shakado, Shotaro Sakisaka, Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka City, Fukuoka 814-0180, Japan.
authors.forename: Akio
authors.initials: A
authors.lastname: Ido
authors.affiliation: Satoshi Shakado, Shotaro Sakisaka, Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka City, Fukuoka 814-0180, Japan.
authors.forename: Yoichi
authors.initials: Y
authors.lastname: Hiasa
authors.affiliation: Satoshi Shakado, Shotaro Sakisaka, Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka City, Fukuoka 814-0180, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Yoshioka
authors.affiliation: Satoshi Shakado, Shotaro Sakisaka, Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka City, Fukuoka 814-0180, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nomura
authors.affiliation: Satoshi Shakado, Shotaro Sakisaka, Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka City, Fukuoka 814-0180, Japan.
authors.forename: Yoshiyuki
authors.initials: Y
authors.lastname: Ueno
authors.affiliation: Satoshi Shakado, Shotaro Sakisaka, Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka City, Fukuoka 814-0180, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Seike
authors.affiliation: Satoshi Shakado, Shotaro Sakisaka, Department of Gastroenterology and Medicine, Faculty of Medicine, Fukuoka University, Fukuoka City, Fukuoka 814-0180, Japan.
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Kumada
keywords: Alpha-fetoprotein; Des-γ-carboxy prothrombin; Hepatitis C virus; Hepatocellular carcinoma; Interferon; Liver cirrhosis; Ribavirin