An Insight Into the Role of Alpha-Fetoprotein (AFP) in the Development and Progression of Hepatocellular Carcinoma

Samban, Swathy S.; Hari, Aparna; Nair, Bhagyalakshmi; Kumar, Ayana. R.; Meyer, Benjamin S.; Valsan, Arun; Vijayakurup, Vinod; Nath, Lekshmi R.

doi:10.1007/s12033-023-00890-0

Cited by 5 publications

(3 citation statements)

References 63 publications

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“…In our study, we observed significant associations between both nomograms and tumor characteristics, as well as AFP levels. AFP, recognized as the most widely used tumor biomarker for HCC, plays a crucial role in the progression of HCC [19]. Additionally, tumor size and number are well-established prognostic factors, with larger tumor size and increased tumor number indicating poorer outcomes [20,21].…”

Section: Discussionmentioning

confidence: 99%

Predictive nomograms based on gamma-glutamyl transpeptidase to prealbumin ratio for prognosis of hepatocellular carcinoma patients without microvascular invasion

Ma,

Xie,

Jin

et al. 2024

BMC Cancer

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Background Hepatocellular carcinoma (HCC) presents a significant threat to individuals and healthcare systems due to its high recurrence rate. Accurate prognostic models are essential for improving patient outcomes. Gamma-glutamyl transpeptidase (GGT) and prealbumin (PA) are biomarkers closely related to HCC. This study aimed to investigate the predictive value of the GGT to PA ratio (GPR) and to construct prognostic nomograms for HCC patients without microvascular invasion. Methods We retrospectively analyzed data from 355 HCC patients who underwent radical hepatectomy at Shengjing Hospital of China Medical University between December 2012 and January 2021. Patients were randomly assigned to a training cohort (n = 267) and a validation cohort (n = 88). The linearity of GPR was assessed using restricted cubic spline (RCS) analysis, and the optimal cut-off value was determined by X-tile. Kaplan–Meier survival curves and log-rank tests were used to investigate the associations between GPR and both progression-free survival (PFS) and overall survival (OS). Cox multivariate regression analysis identified independent risk factors, enabling the construction of nomograms. Time-dependent receiver operating characteristic (ROC) and calibration curves were used to evaluate the accuracy of the nomograms. Decision curve analysis (DCA) assessed the predictive value of the models. Results Patients were categorized into GPR-low and GPR-high groups based on a GPR value of 333.33. Significant differences in PFS and OS were observed between the two groups (both P < 0.001). Cox multivariate analysis identified GPR as an independent risk factor for both PFS (OR = 1.80, 95% CI: 1.24–2.60, P = 0.002) and OS (OR = 1.87, 95% CI: 1.07–3.26, P = 0.029). The nomograms demonstrated good predictive performance, with C-index values of 0.69 for PFS and 0.76 for OS. Time-dependent ROC curves and calibration curves revealed the accuracy of the models in both the training and validation cohorts, with DCA results indicating notable clinical value. Conclusions GPR emerged as an independent risk factor for both OS and PFS in HCC patients without microvascular invasion. The nomograms based on GPR demonstrated relatively robust predictive efficiency for prognosis.

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Section: Discussionmentioning

confidence: 99%

Predictive nomograms based on gamma-glutamyl transpeptidase to prealbumin ratio for prognosis of hepatocellular carcinoma patients without microvascular invasion

Ma,

Xie,

Jin

et al. 2024

BMC Cancer

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“…AFP stimulates cell proliferation mainly through activation of AKT signalling and activation of downstream mTOR signalling; it also activates metastasis by promoting the components required for the activation of the epithelial-mesenchymal transition. Additionally, AFP is capable of evading antitumour immunity by blocking dendritic cells, natural killer cells, T lymphocytes, and tumour-infiltrating lymphocytes[ 30 ]. Recent scientific evidence has demonstrated that AFP can deliver medications to myeloid suppressor cells, which are regenerative and malignant cells that activate or inhibit proliferation[ 31 ].…”

Section: Discussionmentioning

confidence: 99%

Development of a diagnostic nomogram for alpha-fetoprotein-negative hepatocellular carcinoma based on serological biomarkers

He,

Zhang,

Liu

et al. 2024

World J Gastrointest Oncol

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BACKGROUND Hepatocellular carcinoma (HCC) is the third leading cause of cancer-related death worldwide. Serum biomarkers play an important role in the early diagnosis and prognosis of HCC. Because a certain percentage of HCC patients are negative for alpha-fetoprotein (AFP), the diagnosis of AFP-negative HCC is essential to improve the detection rate of HCC. AIM To establish an effective model for diagnosing AFP-negative HCC based on serum tumour biomarkers. METHODS A total of 180 HCC patients were enrolled in this study. The expression levels of GP73, des-γ-carboxyprothrombin (DCP), CK18-M65, and CK18-M30 were detected by a fully automated chemiluminescence analyser. The variables were selected by logistic regression analysis. Several models were constructed using stepwise backward logistic regression. The performance of the models was compared using the C statistic, integrated discrimination improvement, net reclassification improvement, and calibration curves. The clinical utility of the nomogram was assessed using decision curve analysis (DCA). RESULTS The results showed that the expression levels of GP73, DCP, CK18-M65, and CK18-M30 were significantly greater in AFP-negative HCC patients than in healthy controls (P < 0.001). Multivariate logistic regression analysis revealed that GP73, DCP, and CK18-M65 were independent factors for diagnosing AFP-negative HCC. By comparing the diagnostic performance of multiple models, we included GP73 and CK18-M65 as the model variables, and the model had good discrimination ability (area under the curve = 0.946) and good goodness of fit. The DCA curves indicated the good clinical utility of the nomogram. CONCLUSION Our study identified GP73 and CK18-M65 as serum biomarkers with certain application value in the diagnosis of AFP-negative HCC. The diagnostic nomogram based on CK18-M65 combined with GP73 demonstrated good performance and effectively identified high-risk groups of patients with HCC.

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“…9 It is a molecular marker for the diagnosis of liver cancer and has high specicity and sensitivity for HCC, 10 and has been widely used in the screening, surveillance, diagnosis and prognosis evaluation of HCC. 11 Currently, the clinical diagnosis criterion for HCC is that AFP should be greater than 400 ng mL −1 for 8 weeks. 12 More and more researchers have found that in the diagnosis of the disease, compared with individual detection, the combination of multiple ideal markers for disease screening and diagnosis is more meaningful.…”

Section: Introductionmentioning

confidence: 99%

An AgPd NP-based lateral flow immunoassay for simultaneous detection of glycocholic acid and alpha-fetoprotein

Jiang,

Chen,

Liang

et al. 2024

Anal. Methods

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An Insight Into the Role of Alpha-Fetoprotein (AFP) in the Development and Progression of Hepatocellular Carcinoma

Cited by 5 publications

References 63 publications

Predictive nomograms based on gamma-glutamyl transpeptidase to prealbumin ratio for prognosis of hepatocellular carcinoma patients without microvascular invasion

Predictive nomograms based on gamma-glutamyl transpeptidase to prealbumin ratio for prognosis of hepatocellular carcinoma patients without microvascular invasion

Development of a diagnostic nomogram for alpha-fetoprotein-negative hepatocellular carcinoma based on serological biomarkers

An AgPd NP-based lateral flow immunoassay for simultaneous detection of glycocholic acid and alpha-fetoprotein

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