Analysis of Alpha Fetoprotein Levels in Hepatocellular Carcinoma Patients in West Sumatera, Indonesia (original) (raw)
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BMC Gastroenterology
Background and aims: Hepatocellular carcinoma (HCC), the most common type of liver cancer, is one of the leading causes of cancer-related death worldwide with an inferior prognosis. In Indonesia, the average life expectancy is less than 5 months, with most patients being in an advanced stage wherein the survival rate is very low. Early detection through surveillance program is very crucial. HCC guidelines worldwide have provided surveillance recommendation through the examination of α-fetoprotein (AFP) and ultrasound for patients at risk in developing HCC. However, there have been some controversies regarding the usage of AFP concerning its low sensitivity and specificity in detecting HCC. Therefore, the effectiveness of AFP in the surveillance of HCC patients and identifying the parameters most associated with the increase of AFP ≥ 10 ng/ml in Indonesia should be evaluated. Methods: We analyzed medical records of HCC patients and those at high risk of developing HCC through crosssectional study, including patients with cirrhosis and hepatitis B and C, from 2015 to 2017 who underwent treatment at the
2021
Materials & Methods: This cross-sectional descriptive study was conducted in Rehman Medical Institute, Peshawar, Pakistan from January 2018 till December 2019. Data were gathered from the medical records of Endoscopy Unit of Rehman Medical Institute. Patients were separated into three groups on the basis of serum AFP levels: Group I had standard levels of AFP (<20 IU/ml), Group II had moderately raised AFP (20-399 IU/ml), and Group III had significantly raised AFP (>400 IU/ml). Patients were also separated into three groups on the basis of tumor; in Group A tumor size was less than 3 cm, in Group B it was between 3 and 5 cm, and in Group C the size was greater than 5 cm. For categorical variables, the Chi-square and Z test for proportions were applied; the Wilcoxon Rank-Sum (Mann-Whitney) test was used to evaluate the variation in the two categories, and the Kruskal-Wallis Rank test was used to evaluate the difference between categories. A p value ≤0.05 was taken as significan...
International Journal of Clinical Biochemistry and Research
Serum AFP as a poor clinical performance values especially when it comes to deal with the early and AFP-negative diagnostic of HCC. The aim of this work was to assess the contribution of AFP in the diagnosis of HCC. : A total of 95 subjects was enrolled a prospective observational study by consecutive enrolment and divided in two groups. The first group was made up with subjects in whom the diagnosis of HCC had been retained while the second was the control group which was free of HCC. AFP levels were performed by electrochemiluminescence immunoassay on the cobas e411. Data were captured in Excel and analyzed by Ri386 version 4.1.2 binary for macOS 10.13. The Log of median of AFP in HCC subjects was significantly greater than in non HCC subjects 6.91 ng/mL versus 1.43 ng/mL, Wilcoxon < 0.001. At the cut-off of 200 ng/mL, the clinical performances showed an acceptable sensitivity 97.1% CI 95% [93.7 – 100] but a poor specificity 73,8% CI 95% [64.9 – 82.6] and out of the 34 cases of...
International Journal of Clinical Biochemistry and Research, 2023
Background: Serum AFP has a poor clinical performance values especially when it comes to dealing with the early and AFP-negative diagnostic of HCC. This study aimed to assess the contribution of AFP in the diagnosis of HCC. Materials and Methods: A total of 95 subjects were in a prospective observational study by consecutive enrolment and divided into two groups. The first group was made up with subjects in whom the diagnosis of HCC had been retained the second was the control group which was free of HCC. AFP levels were performed by electrochemiluminescence immunoassay on the cobas e411®. Data were captured in Excel and analyzed by Ri386 version 4.1.2 binary for macOS 10.13. Results: Log of AFP median of AFP in HCC subjects was significantly greater than in non HCC subjects 6.91 ng/mL versus 1.43 ng/mL, Wilcoxon p-value < 0.001. At the cutoff of 200 ng/mL, the clinical performances showed an acceptable sensitivity 97.1% CI 95% [93.7-100] but a poor specificity 73,8% CI 95% [64.9-82.6] and out of the 34 cases of HCC, one case (2.9%) was AFP-negative HCC. Conclusion: Our data show an acceptable sensitivity but a weak specificity of AFP as a biomarker for HCC at a cutoff 200 ng/mL. This suggests that AFP should be used with other biomarkers, mainly for the early and AFP-negative HCC diagnosis. This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
Corelation of serum alpha fetoprotein and tumor size in hepatocellular carcinoma
JPMA. The Journal of the Pakistan Medical Association, 2012
To determine the correlation of elevated serum Alpha feto-protein with tumour size in hepatocellular carcinoma. A cross-sectional analytical study was done at Jinnah Postgraduate Medical Centre, Karachi, Medical Unit-III, Ward-7 from January 2009 to June 2010. Patients enrolled in study were known cases of chronic liver disease and were complicated by development of hepatocellular carcinoma; those having metastasis in liver from any where were excluded. Demographic data such as age, gender, residence, were recorded. Detailed clinical history and examination were carried out and recorded in a preformed Performa. Complete blood count, liver function test, total protein, Albumin/Globulin (A/G) ratio, serum Albumin, HBsAg, anti HCV, alpha fetoprotein, ultrasound guided liver biopsy, ultrasound whole abdomen and/or CTscan Abdomen for size and number of tumour were also done. On the basis of alfa fetoprotein level patients were divided in to 3 groups; Group I with normal AFP (< or = 20...
Hepatocellular carcinoma (HCC) and diagnostic significance of A-fetoprotein (AFP)
Journal of Ayub Medical College, Abbottabad : JAMC
Alpha-fetoprotein (alpha-fetoprotein, AFP) is a Glycoprotein, belonging to the intriguing class of onco-development protein. Generally designated as tumour marker, AFP is recognized as an important blood component, having specific diagnostic utilities Elevation of its level up to pathological range in adults correlate with the appearance of several malignant and chronic conditions, such as hepatocellular carcinoma (HCC) and chronic liver disease, respectively. To evaluate the diagnostic significance of AFP in HCC, a study was carried out for a period of two years (Jan 2004 to Dec 2005) A brief history of Patients was taken with clinical symptoms and signs and initial diagnosis. Patients admitted in wards or visiting OPDs with diagnosis or suspicions of HCC and additional conditions of Chronic Liver disease (CLDs), hepatitis C (HCV) and hepatitis B viral (HBV) infections, were selected and classified according to gender. When confirmed, their HCC status was evaluated and classified a...
Journal of IMAB - Annual Proceeding (Scientific Papers)
In this study, we analyzed biochemical parameters in the serum of patients with a diagnosis of hepatocellular carcinoma (HCC) C and B viral etiology. Material/Methods: All patients (31 males and 20 females) with a diagnosis of HCC that were treated at the Clinical Centre of the University of Sarajevo were included in this retrospective-prospective study. Serum alphafetoprotein was analyzed as a tumor marker, and hepatitis markers included HBs Ag, anti-HBs, anti-HBc, anti-HCV and anti-HB. Spearman test and Kolmogorov-Smirnov test were used for correlation and normality analysis, respectively. Results: The largest number of patients (68.62%) had cirrhosis of C viral etiology that developed in cancer. Hepatocellular carcinoma was diagnosed more in men than in women (60.78%). The most patients were middle-aged (41-64 years). HCC was present in the right liver lobe at 82.85% HCV and 87.5% HBV patients. Only 6.25% of HBV patients were both liver lobes affected. All biochemical parameters had very high values, especially AFP and ãGT. Significant differences for AST and ALT were found between men and women. Serum bilirubin levels (total, direct and indirect) and AP are higher in men than women. Hepatitis markers had high values, and the incidence of HBs Ag (78%) and anti HBc (78.72%) was established. Conclusions: A positive correlation was established between AFP and other parameters, while a significant difference between AFP and γGT (r = 0.372, p = 0.008) was confirmed. In addition to imaging methods for determining liver cirrhosis and hepatocellular carcinoma, high values of AFP and γGT, are a powerful diagnostic marker for these diseases.
Cancer, 2014
BACKGROUND: a-Fetoprotein (AFP) is a biomarker commonly used in the management of patients with hepatocellular carcinoma (HCC), although the possible determinants of its serum levels in these patients have not been adequately explored. For this study, the authors evaluated the relevance of demographic, clinical, and oncologic factors to the presence of elevated AFP levels in large cohort of patients with HCC. METHODS: In 4123 patients with HCC who were managed by the Italian Liver Cancer Group, AFP levels were assessed along with their association with demographic, biochemical, clinical, and oncologic characteristics. Patients were subdivided according to the presence of elevated AFP (ie, >10 ng=mL). RESULTS: AFP levels were elevated in 62.4% of patients with HCC. Multivariate logistic regression analysis indicated that being a woman (odds ratio [OR], 1.497; 95% confidence interval [95%CI], 1.250-1.793; P <.0001), the presence of cirrhosis (OR, 1.538; 95% CI, 1.050-2.254; P 5.027), liver disease with viral etiology (OR, 1.900; 95% CI, 1.589-2.272; P <.0001), an elevated alanine aminotransferase level (OR, 1.878; 95% CI, 1.602-2.202; P <.0001), a low albumin level (OR, 1.301; 95% CI, 1.110-1.525; P 5.012), an HCC tumor size >2 cm (OR, 1.346; 95% CI, 1.135-2.596; P 5.001), multinodular HCC (OR, 1.641; 95% CI, 1.403-1.920; P <.0001), and the presence of vascular invasion (OR, 1.774; 95% CI, 1.361-2.311; P <.0001) were associated independently with elevated levels of AFP. Both the median AFP level and the proportion of patients who had elevated levels Original Article increased with decreasing degrees of HCC differentiation (P <.0001). CONCLUSIONS: Sex and features of chronic liver disease were identified as nontumor characteristics that influence serum AFP levels in patients with HCC. These findings should be taken into account as limitations in interpreting the oncologic meaning of this biomarker in clinical practice. Cancer 2014;120:2150-7.
Association of Serum Alpha Fetoprotein (Afp) Levels with Size of Hepatocellular Carsinoma
Pakistan Armed Forces Medical Journal, 2019
Objective: To determine the association between high levels of serum Alpha Fetoprotein (AFP) and tumor size in hepatocellular carcinoma (HCC). Study Design: Cross-sectional analytical study. Place and Duration of Study: Department of Gastroenterology and Hepatology, Pak Emirates Military Hospital, Rawalpindi from June 2015 to June 2017. Material and Methods: Two hundred and thirty six patients diagnosed with HCC were enrolled in the study, out of which 175 provided the required data to perform the association. All demographic data and clinical information was recorded on a predesigned proforma, after taking proper informed consent. The cases were divided into three groups for each variable to evaluate. Concerning the serum alpha fetoprotein levels, they were divided as group 1 (normal level: 400 UI/ml). According to the size of their tumors, the group A contains patients with less than 3 cm. tumors; in group B the tumors are 3 to 5cm. and the group C is formed by patients whose tumo...
International Journal of Clinical Biochemistry and Research, 2023
Background: Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer occurs in people with liver diseases like chronic hepatitis B and hepatitis C virus. Early diagnosis and monitoring of HCC is possible with the help of tumor marker AFP. The aim of the study was to assess whether AFP level is associated with selected liver function tests in hepatocellular carcinoma patients. Materials and Methods: Total 90 individuals are selected, 50 HCC patients with AFP >20ng/ml and 40 subjects (normal LFT and AFP value <10ng> Result: Elevated levels of AFP (p value <0> Conclusion: From the study, it is concluded that LFT and AFP are comparatively elevated in HCC. Treatment is usually not possible with advanced HCC due to failure of not doing proper screening at appropriate time. Early diagnosis and monitoring of HCC are possible with the help of tumor marker AFP. Keywords: Alpha- fetoprotein, Aspartate transaminase, Alanine transaminase, Tumor marker.