Combined Analysis of AFP and HCCR-1 as an Useful Serological Marker for Small Hepatocellular Carcinoma: A Prospective Cohort Study

Abstract

Hepatocellular carcinoma (HCC) is one of the most frequent malignant tumors in the world. The only serological marker widely used for the diagnosis of HCC is alpha-fetoprotein (AFP). Despite that AFP is widely used for the diagnosis of HCC, it has a limit as a serological marker due to its low sensitivity and specificity. The human cervical cancer proto-oncogene 1 (HCCR-1) was previously reported as a new biomarker for HCC. To further evaluate the HCCR-1 as a biomarker for HCC, we conducted the prospective cohort study. We evaluated the significance of simultaneous measurement of 2 tumor markers in the diagnosis of HCC in China, Japan and Korea. Two markers for HCC, AFP and HCCR-1, were measured in the sera obtained from 1,338 patients at the time of initial diagnosis of HCC. Of the 1338 HCC patients, 616 (46%) and 686 (51.3%) were sero-positive for AFP and HCCR-1, respectively. The positive rate for HCC was increased up to 74.1% in combined use of AFP and HCCR-1. Many cases (54%) for AFP-negative HCC were positive for HCCR-1 and vice versa. More importantly, the diagnostic rate for small HCC (< 2 cm) was significantly improved in the combined analysis of AFP and HCCR-1 to 56.9% although it was only 40.1% and 23.4% in the single analysis of HCCR-1 and AFP, respectively. Our result suggests that the HCCR-1 could be an useful biomarker for HCC while the diagnostic rate could be significantly improved in the combined use of HCCR-1 and AFP.

Evaluation of the diagnostic value of alpha‐l‐fucosidase, alpha‐fetoprotein and thymidine kinase 1 with ROC and logistic regression for hepatocellular carcinoma

“…In the present study, the sensitivity of AFU was 72.4% and the specificity was 63.8%. Our finding came in agreement with a Table 2 The mean concentrations of AFU, AFP and TK1 in cases and controls [Median (P 25 Kruskal-Wallis test was carried out among the three groups with three tumor markers: v 2 = 70.311-104.425, all P < 0.001. Mann-Whitney U test was carried out between the following two groups: (1), HCC group versus benign liver disease group: AFU (Z = À1.820, P = 0.069), AFP (Z = À8.570, P < 0.001), TK1 (Z = À5.943, P < 0.001); (2), benign liver disease group versus control group: AFU (Z = À7.984, P < 0.001), AFP (Z = À0.527, P = 0.598), TK1 (Z = À1.575, P = 0.115).…”

Effect of Occupational Exposure to Aflatoxins on Some Liver Tumor Markers in Textile Workers

“…(1) Alpha-fetoprotein (AFP), a serological marker widely used for the diagnosis of HCC, despite its limitations due to low sensitivity and specificity [Zhang et al, 2012]. The AFP tests were based on the principle of a solid phase enzyme-linked immunosorbent assay [Uotila et al, 1981] using AFP ELISA test kit, cat.…”

Diagnostic value of long noncoding RNAs for hepatocellular carcinoma

“…Alpha fetoprotein (AFP), the most widely used tumor marker for HCC, may remain normal in almost 40% of patients with early stage HCC, and even in 15% to 30% of advanced patients. [9,10] Furthermore, patients with chronic hepatitis B (HBV) and/or C may also be with increased AFP concentrations. [11] Ultrasonography is an ideal and cost-effective screening technique method to identify HCC patients in early screening, yet it fails to distinguish nodules of less than 3 cm.…”