Higher Ratio of Serum Alpha-Fetoprotein Could Predict Outcomes in Patients with Hepatitis B Virus-Associated Hepatocellular Carcinoma and Normal Alanine Aminotransferase

The role of serum alpha-fetoprotein (AFP) levels in the surveillance and diagnosis of hepatocellular carcinoma (HCC) is controversial. The aim of this study was to investigate the value of serially measured serum AFP levels in HCC progression or recurrence after initial treatment. A total of 722 con...

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Bibliographic Details
Published in:PloS one 2016-06, Vol.11 (6), p.e0157299-e0157299
Main Authors: Kim, Young-Il, Kim, Hyoung Sang, Park, Joong-Won
Format: Article
Language:English
Subjects:
Aged
Alanine
Alanine transaminase
Alanine Transaminase - blood
alpha-Fetoproteins - analysis
Biology and life sciences
Blood tests
Cancer therapies
Carcinoma, Hepatocellular - blood
Carcinoma, Hepatocellular - complications
Carcinoma, Hepatocellular - therapy
Chronic infection
Correlation analysis
Disease
Disease Progression
Etiology
Female
Gangrene
Hepacivirus - physiology
Hepatitis
Hepatitis B
Hepatitis B - blood
Hepatitis B - complications
Hepatitis B - virology
Hepatitis B virus
Hepatitis B virus - physiology
Hepatitis C
Hepatitis C - blood
Hepatitis C - complications
Hepatitis C - virology
Hepatitis C virus
Hepatocellular carcinoma
Hepatology
Host-Pathogen Interactions
Humans
Infections
Liver cancer
Liver Neoplasms - blood
Liver Neoplasms - complications
Liver Neoplasms - therapy
Logistic Models
Male
Medical diagnosis
Medical imaging
Medical prognosis
Medicine and Health Sciences
Middle Aged
Multivariate Analysis
Neoplasm Recurrence, Local
NMR
Nuclear magnetic resonance
Outcome Assessment (Health Care) - methods
Outcome Assessment (Health Care) - statistics & numerical data
Patients
Predictive Value of Tests
Prognosis
Regression analysis
Republic of Korea
Research and Analysis Methods
Viruses
α-Fetoprotein
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Summary:The role of serum alpha-fetoprotein (AFP) levels in the surveillance and diagnosis of hepatocellular carcinoma (HCC) is controversial. The aim of this study was to investigate the value of serially measured serum AFP levels in HCC progression or recurrence after initial treatment. A total of 722 consecutive patients newly diagnosed with HCC and treated at the National Cancer Center, Korea, between January 2004 and December 2009 were enrolled. The AFP ratios between 4-8 weeks post-treatment and those at the time of HCC progression or recurrence were obtained. Multivariate logistic regression analysis was performed to correlate the post-treatment AFP ratios with the presence of HCC progression or recurrence. The etiology of HCC was related to chronic hepatitis B virus (HBV) infection in 562 patients (77.8%), chronic hepatitis C virus (HCV) infection in 74 (10.2%), and non-viral cause in 86 (11.9%). There was a significant decrease in serum AFP levels from the baseline to 4 to 8 weeks after treatment (median AFP, 319.6 ng/mL vs. 49.6 ng/mL; p< 0.001). Multivariate analysis showed that an AFP ratio > 1.0 was an independently associated with HCC progression or recurrence. Among the different causes of HCC analyzed, this association was significant only for HCC related to chronic hepatitis B (p< 0.001) and non-viral causes (p
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0157299