Alpha-fetoprotein still is a valuable diagnostic and prognosis predicting biomarker in hepatitis B virus infection-related hepatocellular carcinoma

Yao, Mingjie; Zhao, Jiyun; Lu, Fengmin

doi:10.18632/oncotarget.6913

Cited by 46 publications

(33 citation statements)

References 12 publications

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“…AFP is a useful diagnostic marker for HCC, and roughly 50%-70% of adults with HCC have increased levels of AFP. 23,24 In this study, AFP was found to be related to HCC progression from stage A to stage D and was basically positively correlated, which suggests that higher serum levels of AFP were more likely to present with advanced stage HCC with severe liver dysfunction and compromised performance status. γ-GT mainly exists in liver cell membrane and microsome.…”

Section: Discussionmentioning

confidence: 56%

Clinical characteristics analysis of 1180 patients with hepatocellular carcinoma secondary to hepatitis B, hepatitis C and alcoholic liver disease

Zhao

Zhu

Han

et al. 2019

Clinical Laboratory Analysis

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Objective To determine the clinical and liver stiffness characteristics of a cohort of Chinese patients with Hepatocellular carcinoma in different stages of Barcelona clinic liver cancer. Methods Details of 1180 patients with Hepatocellular carcinoma referred from October 2014 to November 2017 were collected retrospectively. Demographic data, etiology, clinical, and biochemical details were retrospectively analyzed. The changes of liver stiffness in different etiologies and different stages of Barcelona clinic liver cancer were especially analyzed. Results The onset age was 60.33 ± 9.11 (range 24‐84) years, 9 cases were ≤40 years, 572 cases were 41‐60 years, males accounted for 83.92%, females accounted for 16.08%; 599 cases were ≥61 years, males accounted for 78.25%, females accounted for 21.75%. Compared with males, the proportion of females ≥61 is higher than that of men. Majority (n = 787; 66.69%) had HBV infection; second commonest cause was HCV infection (n = 217; 18.39%). More patients with HBV infection were 41‐60 years (69.06%) and were younger than HCV patients. There was no statistical difference in etiology, age, gender, and distribution of diabetes mellitus among different Barcelona clinic liver cancer stages (P > .05). The overall Hepatocellular carcinoma (HCC) was found to be positively correlated with alkaline phosphatase, γ‐glutamyltransferase, and alpha‐fetoprotein and liver stiffness measurement values from stage A to stage D (P < .05). ANOVA analysis showed that the overall liver stiffness measurement among the four BCLC stages was found to be statistically significant different in HBV‐infected and HCV‐infected HCC patients. Conclusion Majority (99.24%) were patients aged >40 years old. Male is a high incidence population. In etiological analysis, HBV dominates HCC occurrence, HBV‐, HCV‐, and alcohol‐associated HCC have distinct clinical and biochemical characteristics, necessitating different screening policies to optimize HCC surveillance and management.

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Section: Discussionmentioning

confidence: 56%

Clinical characteristics analysis of 1180 patients with hepatocellular carcinoma secondary to hepatitis B, hepatitis C and alcoholic liver disease

Zhao

Zhu

Han

et al. 2019

Clinical Laboratory Analysis

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“…In order to improve patients’ prognosis and long-term survival, early diagnosis of HCC is essential to implement curative interventions [5]. Alpha-fetoprotein (AFP) is the most commonly used serological biomarker for HCC [6, 7]. However, the clinical diagnostic accuracy of AFP is unsatisfactory due to low sensitivity and specificity, and is no more recommended by European Association for the Study of the Liver (EASL) [8, 9].…”

Section: Introductionmentioning

confidence: 99%

Serum Golgi protein 73 is not a suitable diagnostic marker for hepatocellular carcinoma

et al. 2017

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Golgi protein 73 (GP73) has been suggested as a serum marker for the diagnosis of hepatocellular carcinoma (HCC). However, this has been challenged in recent years. In the present study, we found that the serum GP73 increased in HCC patients with cirrhosis but not in those without cirrhosis. The receiver operating characteristic curve (ROC) analysis demonstrated that serum GP73 had poor performance for differentiating HCC patients from cirrhosis patients. In addition, the immunohistochemistry revealed that aberrant expression of GP73 was primarily observed in cirrhotic and tumor liver tissues from both cirrhosis and HCC patients, but rarely in non-cirrhotic liver tissues from HCC patients without cirrhosis. Moreover, serum Alpha-fetoprotein in HCC patients with cirrhosis decreased sharply after resection of tumor tissue, while the serum GP73 remained stable. These data indicated that the background of cirrhosis was related to the elevation of serum GP73 in HCC patients. In conclusion, serum GP73 is not a suitable diagnostic marker for HCC.

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“…In China, AFP is the only serum biomarker included in the diagnostic criteria for HCC, whereas other countries suggest the use of a combination of non-invasive biomarkers for surveillance in high-risk populations. At present, AFP is the most effective diagnostic indicator for HCC (36). A recent meta-analysis of the diagnostic value of AFP in HCC determined a pooled sensitivity of 66%, a specificity of 86% and an AUC value of 0.87 (37).…”

Section: Discussionmentioning

confidence: 99%

Serum levels of anti‑sperm‑associated antigen 9 antibody are elevated in patients with hepatocellular carcinoma

Ren

Zou

et al. 2017

Oncol Lett

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Abstract. At present, there is a high incidence of viral hepatitis and high mortality rates due to hepatocellular carcinoma (HCC) in China. In the current study, the quantification of antibodies against the cancer-testis antigen sperm-associated antigen 9 (SPAG9), alone and combined with α-fetoprotein (AFP), were evaluated as biomarkers for the diagnosis of HCC. The levels of anti-SPAG9 antibody and AFP were quantified in serum samples from patients with HCC and hepatitis or cirrhosis, as well as healthy volunteers. The results revealed that the serum levels of anti-SPAG9 immunoglobulin G antibody in patients with HCC were significantly higher compared with those in patients with hepatitis/cirrhosis and healthy controls. Using receiver operator characteristic curves, the area under the curve (AUC, 0.870) of SPAG9 as a diagnostic marker of HCC was significant [P<0.001; 95% confidence interval (CI), 0.793-0.947], whereas the AUC of AFP was 0.832 (P<0.001; 95% CI, 0.736-0.928). Serum anti-SPAG9 antibody levels exhibited significant potential for the differential diagnosis of HCC, with an AUC value of 0.729, (P=0.008; 95% CI, 0.559-0.899). Similarly, serum AFP levels exhibited significant value for the differential diagnosis of HCC, with an AUC value of 0.842 (P<0.001; 95% CI, 0.732-0.953). When combined with quantification of AFP, the diagnostic sensitivity and specificity of anti-SPAG9 levels were increased. In summary, the results suggested that anti-SPAG9 antibody is a potential early diagnostic marker of HCC. IntroductionHepatitis B virus (HBV) and hepatitis C virus (HCV) infections are major risk factors for the development of human hepatocellular carcinoma (HCC) (1-3). The incidence of HCC in China is ~100/100,000 population, and a principal component of the attributable risk is chronic HBV infection (4), with >50% of the global HCC burden attributed to HBV (5). In China, ~10% of patients with HCC suffer from HCV infection, and certain patients have HBV and HCV co-infections (6). In the USA, Europe and Japan, >50% of current cases of HCC are attributable to HCV infection, and the majority of these patients have cirrhosis (7-9). The time from initial diagnosis of chronic hepatitis to the development of HCC may span several decades; once cirrhosis is established, HCC develops at a yearly rate of 1-4% (10).In China, the majority of patients with HCC present with advanced-stage disease, and HCC has become the second leading cause of mortality (11). Early diagnosis relies on non-invasive biomarkers, imaging and clinical parameters, with markers such as α-fetoprotein (AFP), the proportion of the fucosylated isoform of AFP to total AFP, AFP-L3 and des-gamma-carboxy-prothrombin (DCP) being Food and Drug Administration-approved for use in the surveillance of high-risk populations (12,13). However, the clinical value of these biomarkers is a subject of debate (14). In Japan, three biomarkers are combined for surveillance (15,16), and this combined testing has a high level of sensitivity and specificity (17,18). In Ch...

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Alpha-fetoprotein still is a valuable diagnostic and prognosis predicting biomarker in hepatitis B virus infection-related hepatocellular carcinoma

Cited by 46 publications

References 12 publications

Clinical characteristics analysis of 1180 patients with hepatocellular carcinoma secondary to hepatitis B, hepatitis C and alcoholic liver disease

Clinical characteristics analysis of 1180 patients with hepatocellular carcinoma secondary to hepatitis B, hepatitis C and alcoholic liver disease

Serum Golgi protein 73 is not a suitable diagnostic marker for hepatocellular carcinoma

Serum levels of anti‑sperm‑associated antigen 9 antibody are elevated in patients with hepatocellular carcinoma

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