2014
DOI: 10.1053/j.gastro.2014.01.045
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A New Laboratory-Based Algorithm to Predict Development of Hepatocellular Carcinoma in Patients With Hepatitis C and Cirrhosis

Abstract: Background & Aims Serum levels of α-fetoprotein (AFP) are influenced not only by the presence of hepatocellular carcinoma (HCC) but also by underlying severity and activity of liver disease, which is reflected by liver function tests. We constructed an AFP-based algorithm that included these factors to identify patients at risk for HCC, and tested its predictive ability in a large set of patients with cirrhosis. Methods We used the national Veterans Administration hepatitis C virus (HCV) clinical case regist… Show more

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Cited by 170 publications
(139 citation statements)
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“…High AFP levels are also observed in cirrhosis with high inflammatory activity and may correlate with aminotransferase levels [36,37]. A cut-off value of 20 ng/ml was shown to optimally level sensitivity and specificity of AFP; however, sensitivity remained at only 60% [38,39]. Of note, reducing the cut-off resulted in a considerable number of false-positive findings which would require additional and, frequently, unnecessary tests.…”
Section: Biomarkers For Screening and Detectionmentioning
confidence: 97%
“…High AFP levels are also observed in cirrhosis with high inflammatory activity and may correlate with aminotransferase levels [36,37]. A cut-off value of 20 ng/ml was shown to optimally level sensitivity and specificity of AFP; however, sensitivity remained at only 60% [38,39]. Of note, reducing the cut-off resulted in a considerable number of false-positive findings which would require additional and, frequently, unnecessary tests.…”
Section: Biomarkers For Screening and Detectionmentioning
confidence: 97%
“…Their model-predicted probability levels showed a very close relationship with raw frequencies of HCC that only deviated in risks higher than 90% where there is no practical significance. This model is yet to be tested on other populations with liver disease due to causes other than HCV and in populations outside of the Veterans Affair (VA) Health system where males predominate 20 . The recently published ADRESS model can be used for predicting HCC probability in patients with cirrhosis using the variables of age, diabetes, race, cirrhosis etiology, sex and severity of liver dysfunction.…”
Section: Hepatocellular Carcinomamentioning
confidence: 99%
“…El Serag et al [9] have developed a score taking advantage of the fact that false-positive AFP values are associated with active hepatic inflammation. Therefore an elevated AFP in the presence of elevated ALT is less likely to be associated with HCC than if the ALT was normal.…”
Section: Assessment Of Riskmentioning
confidence: 99%