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Abstract

The aim of the current study is to identify underlying pathology associated with elevated serum alpha-fetoprotein (AFP; >20 ng/ml) among patients referred to a tertiary-care academic medical center with emphasis in liver diseases, hepatobiliary surgery, and liver transplantation. From May 1992 to April 1997, 386 patients (320 adults and 66 children) with elevated AFP (>20 ng/ml) were identified from the Medical Archival System (MARS) database at the University of Pittsburgh Medical Center. The medical records from all these patients were retrospectively reviewed. Radiological, pathological, and biochemical profiles were obtained at the time of documented elevated AFP. These patients included: 218 adults with malignancies, 102 adults without malignancies, 18 children and infants with malignancies, and 48 children and infants without malignancies. Thirty-two percent of adults were found to have raised AFP with liver disease and without hepatocellular carcinoma and 78% had some type of malignancy, predominantly hepatocellular carcinoma. Seventy-three percent of infants and children had elevated AFP without malignancy. Based on our findings, we recommend that all patients (adults, infants and children) with raised AFP of >20 ng/ml should undergo thorough evaluation to rule out malignant disease.

Pediatric Hepatocellular Carcinoma, a Single Center Study from the South of Iran: Case Series

“…Diagnosis of HCC is based on clinicopathologic and radiologic findings; however, AFP plays an important role in the early diagnosis and follows up of the patients with cirrhosis (16). Most of our cases had elevated AFP, which most of them were significantly high, therefore, our study confirms the value of AFP in the diagnosis of HCC even in the pediatric age group (17).…”

HCC-ART score, a simple, highly sensitive and specific test for early diagnosis of hepatocellular carcinoma: a large-scale, multicentre study

“…It has been hypothesised that an age-associated decrease in DNA repair contributes to the development of HCC (Goukassian et al , 2000; Anisimov, 2007). Chronic hepatitis or cirrhosis raise AFP in 20% and 40% of patients, respectively, and tend to fluctuate in parallel with underlying inflammatory activity (Johnson, 2001; Kashyap et al , 2001). Also, ALT and AST ratio levels were significantly associated with the incidence of HCC (Dufour et al , 2000).…”

Predictors of post-hepatectomy liver failure in patients undergoing extensive liver resections for hepatocellular carcinoma

“…Based on physiological factors and a literature review of similar studies, the parameters considered as possible predictors for risk of postoperative hepatic failure were selected and divided into 4 categories 910111213141516…”

“…The second category consisted of biochemical factors such as pre-operative albumin, bilirubin, prothrombin time, creatinine, platelet count, alpha-fetoprotein (AFP), total white blood cells, lymphocyte counts, neutrophil counts and ICG R15 9101112131415. The third category consisted of composite scores including Child-Turcotte-Pugh (CTP) score and Model for End-Stage Liver Disease (MELD) score, both of which were calculated pre-operatively based on the closest set of values prior to surgery 16.…”