Diagnostic and Prognostic Role of α-Fetoprotein in Hepatocellular Carcinoma: Both or Neither?

@article{Farinati2006DiagnosticAP,
  title={Diagnostic and Prognostic Role of $\alpha$-Fetoprotein in Hepatocellular Carcinoma: Both or Neither?},
  author={Fabio Farinati and Dario Marino and Massimo De Giorgio and Anna Baldan and Maria Chiara Cantarini and Carmela Cursaro and Gian Ludovico Rapaccini and Paolo Del Poggio and Maria Anna Di Nolfo and Luisa Benvegnu' and Marco Zoli and Franco Borzio and Mauro Bernardi and Franco Trevisani},
  journal={The American Journal of Gastroenterology},
  year={2006},
  volume={101},
  pages={524-532}
}
BACKGROUND:The clinical usefulness of α-fetoprotein (AFP) in hepatocellular carcinoma (HCC) management is debatable. [...] Key Method In 66 patients with histological diagnosis, the pathologists evaluated p53 overexpression, MIB 1 labeling index, BCL-2 positive cells (index of apoptosis), and CD44 (adhesion molecule) positivity.RESULTS:Patients were divided into three AFP groups: normal (<20 ng/mL) [46%], elevated (21–400 ng/mL) [36%], and diagnostic (>400 ng/mL) [18%]. Statistical correlations were significant…Expand
Value of α-fetoprotein in association with clinicopathological features of hepatocellular carcinoma.
TLDR
HCC differentiation, size and vascular invasion have strong relationships with AFP, poor differentiation and HCC size ≥ 10 cm are independent predictors of elevated AFP, and BCLC shows better relationship with AFP. Expand
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TLDR
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. Expand
Is inconsistency of alpha-fetoprotein level a good prognosticator for hepatocellular carcinoma recurrence?
TLDR
Patients in group I with inconsistent AFP levels had a longer recurrence interval and worse recurrence-to-death survival rate than those in group II, and this clinical presentation may be caused by a delay in the detection of HCC recurrence. Expand
Prognosis evaluation in alpha-fetoprotein negative hepatocellular carcinoma after hepatectomy: comparison of five staging systems.
  • X-f Zhang, X. Qi, +4 authors Y. Lv
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TLDR
BCLC has the strongest potential in prognosis evaluation in AFP negative patients and the optimal staging system in predicting the survival of these patients. Expand
α-Fetoprotein mRNA in situ hybridisation is a highly specific marker of hepatocellular carcinoma: a multi-centre study
TLDR
AFP mRNA detected by RNAscope is highly specific for hepatocytic malignancy and may serve as a novel diagnostic biomarker for HCC. Expand
Alpha-fetoprotein for Diagnosis, Prognosis, and Transplant Selection.
TLDR
The inclusion of AFP among transplant criteria would improve the ability of identifying poor candidates due to an unacceptable risk of HCC recurrence regardless of tumor burden, and of adopting flexible morphological selection criteria. Expand
Prognostic Role of Serum Alpha-Fetoprotein in Hepatocellular Carcinoma Patients with Radiofrequency Ablation
TLDR
Pretreatment AFP is not significantly correlated with age, baseline lesion number or size, baseline Child score or class, post RFA recurrence or death, and the ROC curve showed that AFP had inadequate accuracy to discriminate survivors and deceased patients and to discriminate patients with recurrence from those without recurrence. Expand
Usefulness of alpha-fetoprotein response in patients treated with sorafenib for advanced hepatocellular carcinoma.
TLDR
Assessment of AFP response may be considered as an alternative to RECIST to capture sorafenib activity in HCC and improve prognostic usefulness of imaging-based Response Evaluation Criteria in Solid Tumors. Expand
Elevated alpha-fetoprotein: differential diagnosis - hepatocellular carcinoma and other disorders.
TLDR
A high or increasing serum biomarker level can be predictive of the eventual development of HCC, large tumor size, advanced stage, extrahepatic metastases, portal vein thrombosis, and postoperative HCC recurrence. Expand
Assessment of Alpha-Fetoprotein in the Diagnosis of Hepatocellular Carcinoma in Middle Eastern Patients
TLDR
In cirrhotic patients, AFP has a poor screening and diagnostic value for HCC and underlying viral etiology fails to influence the diagnostic accuracy of this test. Expand
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It is concluded that AFP is useful not only for diagnosis, but also as a prognostic indicator in patients with HCC, and cannot be considered a sensitive tumor marker, particularly during the early stages in HBsAg-negative patients. Expand
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