Distinctions Between Clinicopathological Factors and Prognosis of Alpha-fetoprotein Negative and Positive Hepatocelluar Carcinoma Patients

Abstract

Serum alpha-fetoprotein (AFP) is a significant marker for clinical diagnosis and prognosis evaluation in hepatocellular carcinoma (HCC) patients. However, some proportion of liver cancer patients are AFP-negative (AFP ≤20ng/ml). In order to study the differences between clinicopathological factors and prognosis of alphafetoprotein negative and positive patients, a total of 114 cases (41 AFP-negative and 73 AFP-positive) were selected for our research. By systematically statistical analysis, the results demonstrated that compared with AFPnegative patients, AFP-positive examples were more likely to feature cirrhosis nodules, non-complete neoplasm capsules, and a poor Edmondson-steiner grade. Furthermore, AFP-negative patients demonstrated a favorable long-term prognosis. By univariate analysis and multivariate analysis with Cox's proportional hazards model, multiple tumors were found to be independent risk factors for worse survival of AFP negative patients; however, less tumor-free margins, multiple tumors and Edmondson-steiner grades Ⅲ/Ⅳ, proved to be independent risk factors leading to a poor prognosis of AFP positive cases. Finally, we can infer that high levels of AFP signify a highly malignant tumor and unfavorable prognosis.

Clinicopathological Characteristics of Hepatocellular Carcinoma in Turkey

“…The value over 200 ng/ml is reliable as tumor marker and a consistent rise in AFP level may also reliable marker during the follow up (Giannelli, 2006). Xu J et al stated that high levels of AFP (>20 ng/ml) signify a highly malignant tumor and unfavorable prognosis (Xu et al, 2012). In our study fifty four (55.1%) patients had elevated AFP (>20 ng/ml) which is consistent with previous studies (Daniele et al, 2004;Marrero et al, 2004 ).…”

Retrospective Evaluation of Discrepancies between Radiological and Pathological Size of Hepatocellular Carcinoma Masses

“…Although the prognosis of HCC is extremely complicated and depends not only on the stage of the tumor, but also on the residual liver function and serum a-fetoprotein (AFP) levels (Xu et al, 2012) …”

“…Although the prognosis of HCC is extremely complicated and depends not only on the stage of the tumor, but also on the residual liver function and serum a-fetoprotein (AFP) levels (Xu et al, 2012), the tumor size is still an independent pivotal factor for clinical reference. The 2013 American Joint Committee on Cancer (AJCC) TNM staging system for HCC stratifies tumor mass at 5cm criterion for multiple tumors (multiple tumors none more than 5 cm belong to T2; multiple tumors more than 5 cm belong to T3a).…”

Screening differential expression of serum proteins in AFP-negative HBV-related hepatocellular carcinoma using iTRAQ –MALDI-MS/MS

“…Moreover in early stage HCC, small lesions less than 3cm, have increased AFP levels (<20 ng/mL) in only 20-30% of cases [8] however, this percentage is continually falling with the development of better imaging techniques. We defined this group as having AFP-Negative hepatocellular carcinoma [9]. According to previous studies, approximately 40% of early HCC patients and 15-20% with advanced HCC patients are AFP-Negative [10].…”