Y C Peng1, C S Chan, G H Chen. 1. Department of Internal Medicine, Taichung Veterans General Hospital, Taiwan.
Abstract
BACKGROUND/AIMS: In Taiwan, most cases of hepatocellular carcinoma (HCC) are hepatitis B virus (HBV) or hepatitis C virus (HCV) related. The serum alpha-fetoprotein (AFP) level is an important factor in the diagnosis of HCC. There have been many studies discussing the role of AFP in diagnosing HBV-related HCC, but only few concerning HCV-related HCC. In this study, we aimed at analyzing the distribution of AFP levels in anti-HCV positive patients with and without HCC and evaluating the effectiveness of serum AFP levels in screening HCV-related HCC. METHODOLOGY: From 1993-1996, we collected the AFP data of 205 HCC patients retrospectively, who were anti-HCV positive. For comparison, 131 randomized anti-HCV positive patients without evidence of HCC served as the control group. We analyzed the AFP distribution in both groups over the following ranges: < or = 5 ng/ml, > 5-20 ng/ml, > 20-50 ng/ml, > 50-100 ng/ml, > 100-200 ng/ml and > 200-400 ng/ml, and > 400 ng/ml. RESULTS: The distributions of AFP levels in anti-HCV positive patients with HCC were 13.2%, 21.5%, 11.2%, 4.9%, 4.4%, 7.3%, and 37.6%. The distributions in anti-HCV positive patients without evidence of HCC were 34.3%, 55.0%, 8.4%, 1.5%, 0.8%, 0%, 0%. CONCLUSIONS: We found the differences in AFP to be statistically significant between anti-HCV positive patients with and without HCC. A serum AFP level of more than 200 ng/ml highly indicates HCC. However, there is a large overlap between these 2 groups. Thus, in anti-HCV positive patients, AFP level is not a good single reference for diagnosis of HCC. Anti-HCV positive patients should be routinely screened for HCC by image studies along with serum AFP level.
RCT Entities:
BACKGROUND/AIMS: In Taiwan, most cases of hepatocellular carcinoma (HCC) are hepatitis B virus (HBV) or hepatitis C virus (HCV) related. The serum alpha-fetoprotein (AFP) level is an important factor in the diagnosis of HCC. There have been many studies discussing the role of AFP in diagnosing HBV-related HCC, but only few concerning HCV-related HCC. In this study, we aimed at analyzing the distribution of AFP levels in anti-HCV positive patients with and without HCC and evaluating the effectiveness of serum AFP levels in screening HCV-related HCC. METHODOLOGY: From 1993-1996, we collected the AFP data of 205 HCC patients retrospectively, who were anti-HCV positive. For comparison, 131 randomized anti-HCV positive patients without evidence of HCC served as the control group. We analyzed the AFP distribution in both groups over the following ranges: < or = 5 ng/ml, > 5-20 ng/ml, > 20-50 ng/ml, > 50-100 ng/ml, > 100-200 ng/ml and > 200-400 ng/ml, and > 400 ng/ml. RESULTS: The distributions of AFP levels in anti-HCV positive patients with HCC were 13.2%, 21.5%, 11.2%, 4.9%, 4.4%, 7.3%, and 37.6%. The distributions in anti-HCV positive patients without evidence of HCC were 34.3%, 55.0%, 8.4%, 1.5%, 0.8%, 0%, 0%. CONCLUSIONS: We found the differences in AFP to be statistically significant between anti-HCV positive patients with and without HCC. A serum AFP level of more than 200 ng/ml highly indicates HCC. However, there is a large overlap between these 2 groups. Thus, in anti-HCV positive patients, AFP level is not a good single reference for diagnosis of HCC. Anti-HCV positive patients should be routinely screened for HCC by image studies along with serum AFP level.
Authors: Mohamed I F Shariff; Jin Un Kim; Nimzing G Ladep; Asmaa I Gomaa; Mary M E Crossey; Edith Okeke; Edmund Banwat; Imam Waked; I Jane Cox; Roger Williams; Elaine Holmes; Simon D Taylor-Robinson Journal: J Clin Exp Hepatol Date: 2017-03-15