Korean J Gastroenterol.  2006 Nov;48(5):321-326.

Usefulness of Serum alpha-fetoprotein (AFP) as a Marker for Hepatocellular Carcinoma (HCC) in Hepatitis C Virus Related Cirrhosis: Analysis of the Factors Influencing AFP Elevation without HCC Development

  • 1Department of Internal Medicine, College of Medicine, Inje University, Ilsanpaik Hospital, Goyang, Korea. jslee@ilsanpaik.ac.kr


BACKGROUND/AIMS: Serum alpha-fetoprotein (AFP) is frequently used for the diagnosis of hepatocellular carcinoma (HCC). Most available data concerning AFP came from studies of patients with chronic hepatitis B or mixed etiologies. Studies concerning the diagnostic value of AFP for HCV-related liver cirrhosis (LC) are limited. We evaluated the factors influencing AFP elevation in the absence of HCC and analyzed the diagnostic value of serum AFP in HCC surveillance of HCV-related LC patients. METHODS: We enrolled 55 patients of HCV-related LC with HCC and 62 patients without HCC as a case-control study were analyzed. The sensitivity and specificity were calculated and the clinical and biochemical factors influencing serum AFP levels. RESULTS: The sensitivities and specificities of serum AFP for the detection of HCC in HCV-related LC were 72.7% and 59.7% for AFP> or =20 ng/mL, and 47.3% and 92.5% for AFP> or =100 ng/mL, respectively. Elevated serum AST was independently associated with elevated serum AFP level in HCV-related LC. In cases of AST< or =2 x upper limit of normal (ULN), the specificity of AFP> or =100 ng/mL for the diagnosis of HCC was 100%. However, in case of AST>2 x ULN, the specificity was 85.0% for AFP> or =100 ng/mL and 95.0% for AFP> or =200 ng/mL. CONCLUSIONS: Serum AST levels influence serum AFP level in HCV-related LC. In cases of AST< or =2 x ULN, AFP greater than 100 ng/mL highly indicates HCC in HCV-related LC, but not in case of AST>2 x ULN.


alpha-fetoproteins; Carcinoma; hepatocellular; Aspartate aminotransferases; Hepatitis C; chronic; Liver cirrhosis

MeSH Terms

Carcinoma, Hepatocellular/complications/*diagnosis/pathology
Diagnosis, Differential
Hepatitis C/*complications/immunology/virology
Liver Cirrhosis/*virology
Liver Neoplasms/complications/*diagnosis/pathology
Middle Aged
Retrospective Studies
Sensitivity and Specificity
Tumor Markers, Biological/*blood
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