Value of alpha-fetoprotein and clinical characteristics in patients with liver neoplasm

Neoplasma. 2014;61(2):218-24. doi: 10.4149/neo_2014_028.

Abstract

This article aimed to investigate the value of α-fetoprotein (AFP) for the diagnosis of hepatocellular carcinoma (HCC) and to evaluate the relationship between AFP and various clinical variables of HCC comprehensively. A retrospective study of postoperative patients diagnosed with liver neoplasm from two Chinese centers was enrolled in our study.A total of 3050 patients were included. The best cut-off point of AFP for the diagnosis of HCC was 20ng/ml with ideal sensitivity (69.74%), specificity (91.18%), LR (4.12) and YI (0.61). Non-HBV infection patients showed the highest specificity (94.44%) but lowest sensitivity (60.13%). In HBV infection. Patients, HBsAg, HBeAb, and HBcAb positive patients had the highest sensitivity (79.55%) and specificity (58.49%). AFP levels increased significantly in symptomatic patients (p=0.011). Those patients with tumor sizes ≥10cm had much higher serum AFP level compared with smaller tumors ones (p=0.014). AFP levels increased remarkably in patients with vascular invasion (p=0.015). Stepwise logistic regression showed tumor size (≥10cm) was an independent predictor of elevated AFP (OR=2.743, 95%CI: 1.167-6.447, P=0.021). The best discriminating AFP value for the diagnosis of HCC is 20ng/ml; HBsAg, HBeAb and HBcAb positive patients have the optimal sensitivity and specificity; tumor size ≥ 10cm is an independent predictor of elevated AFP.

Keywords: hepatocellular carcinoma, alpha-fetoprotein, diagnosis, hepatitis virus B.

MeSH terms

  • Adult
  • Biomarkers, Tumor / blood*
  • Carcinoma, Hepatocellular / blood
  • Carcinoma, Hepatocellular / diagnosis*
  • Carcinoma, Hepatocellular / pathology
  • Female
  • Hepatitis B / blood
  • Hepatitis B Core Antigens / blood
  • Hepatitis B Surface Antigens / blood
  • Humans
  • Liver Neoplasms / blood
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / pathology
  • Logistic Models
  • Male
  • Middle Aged
  • ROC Curve
  • alpha-Fetoproteins*

Substances

  • Biomarkers, Tumor
  • Hepatitis B Core Antigens
  • Hepatitis B Surface Antigens
  • alpha-Fetoproteins