The Postresection Alpha-Fetoprotein in Cirrhotic Patients with Hepatocellular Carcinoma. An Independent Predictor of Outcome

2014 ◽  
Vol 18 (4) ◽  
pp. 701-708 ◽  
Author(s):  
Marc-Antoine Allard ◽  
Antonio Sa Cunha ◽  
Aldrick Ruiz ◽  
Eric Vibert ◽  
Mylène Sebagh ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Independent Predictor ◽  
Alpha Fetoprotein ◽  
Cirrhotic Patients

scholarly journals Plasma interleukin-17 and alpha-fetoprotein combination effectively predicts imminent hepatocellular carcinoma occurrence in liver cirrhotic patients

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kung-Hao Liang ◽  
Ming-Wei Lai ◽  
Yang-Hsiang Lin ◽  
Yu-De Chu ◽  
Chih-Lang Lin ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Characteristic Curve ◽  
Alpha Fetoprotein ◽  
Enzyme Linked Immunosorbent Assay ◽  
Interleukin 17 ◽  
Medical Need ◽  
Tumor Tissues ◽  
Resected Tumor ◽  
Cirrhotic Patients ◽  
A Prospective Study

Abstract Background Predicting imminent hepatocellular carcinoma (HCC) in liver cirrhotic patients is an unmet medical need. We aimed to investigate circulatory biomarkers and their optimum combinations in a prospective study. Methods We investigated plasma interleukin 17 (IL-17) concentrations, quantified using enzyme-linked immunosorbent assay (ELISA), for the prediction of HCC in a large cohort of 404 HCC-naïve liver cirrhotic patients regularly followed after recruitment. Additionally, IL-17 in surgically resected tumor tissues were evaluated using immunohistochemistry staining. Results IL-17 was detected in HCC tissues. The IL-17 concentrations in the peripheral blood do not have correlation with an extensive list of 31 common demographic, metabolic and liver function variables in the cohort of liver cirrhotic patients. Furthermore, patients stratified by IL-17 and alpha-fetoprotein (AFP) showed distinctive cumulative incidence of HCC. Imminent HCC, defined here as HCC occurrence within 1 year, can be predicted by IL-17 alone with an area under the receiver operating characteristic curve [AUC] of 0.762 (P = 0.002). An multivariate analysis showed that age, hepatitis C viral infection, AFP and IL-17 were four independent factors associated with imminent HCC (adjusted P = 0.03, 0.041, 0.024 and 0.008 respectively). An explicit risk score (R) combining the concentrations of two plasma biomarkers, AFP and IL-17, achieved a high AUC of 0.933 (95% confidence interval 0.893–0.972, P < 0.001) in predicting imminent HCC, with 100% sensitivity and 79.9% specificity at the optimum cutoff. The score is defined as: $${\text{R}} = (2.6914)*{\text{IL-17}} + (0.3909)*{\text{AFP}} - (0.80812875)*{\text{IL-17}}^{2} + (0.10288876884)*{\text{IL-17}}^{2} *{\text{AFP}}.$$ R = ( 2.6914 ) ∗ IL-17 + ( 0.3909 ) ∗ AFP - ( 0.80812875 ) ∗ IL-17 2 + ( 0.10288876884 ) ∗ IL-17 2 ∗ AFP . Conclusions The circulatory IL-17 concentration is a predictor of subsequent HCC occurrence in liver cirrhotic patients. The combination of AFP and IL-17 is highly effective in predicting imminent HCC within 1 year.

Hepatocellular Carcinoma Occurrence/Recurrence after Direct-Acting Antivirals for Hepatitis C in Egyptian Cohort: Single-Center Experience

2019 ◽  
Vol 37 (6) ◽  
pp. 488-497
Author(s):  
Sameh A. Lashen ◽  
Mohammed M. Shamseya ◽  
Marwa A. Madkour
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
De Novo ◽  
Independent Predictor ◽  
Alpha Fetoprotein ◽  
Direct Acting Antivirals ◽  
Single Center ◽  
Single Center Experience ◽  
Direct Acting ◽  
Hcc Recurrence

Background: Conflicting data have been published about the risk of hepatocellular carcinoma (HCC) following direct-acting antivirals (DAAs). We investigated the incidence of HCC occurrence/recurrence after DAAs therapy. Patients and Methods: Retrospectively, we analyzed data of 392 patients with F3–4 fibrosis and cirrhosis treated by DAAs during the period from August 2015 to May 2018. In HCC-experienced patients, HCC treatment modality, and the duration between HCC management and DAAs initiation were recorded. In all patients, pretreatment clinicolaboratory evaluation, and imaging before, during and after DAAs were done. Results: De novo HCC occurred in 7.6% of naïve patients, while recurrence appeared in 28% of patients with previous HCC. Pretreatment alpha-fetoprotein was an independent predictor of HCC occurrence, while the time between HCC ablation and the beginning of DAAs was the only predictor of HCC recurrence (p < 0.001). Half of the patients who started DAAs before 6 months had HCC recurrence, while patients who started DAAs at ≥6 months had no recurrence (p< 0.0001). Conclusions: Although HCC occurrence after DAAs was not high, recurrence was apparently high. Pretreatment alpha-fetoprotein is a predictor for de novo HCC. The time between HCC ablation and DAAs was the strongest predictor of recurrence.

A clinical study of lectin-reactive alpha-fetoprotein as an early indicator of hepatocellular carcinoma in the follow-up of cirrhotic patients

Hepatology ◽  
1995 ◽  
Vol 22 (3) ◽  
pp. 802-807 ◽  
Author(s):  
Katsuya Shiraki ◽  
Koujirou Takase ◽  
Yukihiko Tameda ◽  
Minoru Hamada ◽  
Yoshitane Kosaka ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Study ◽  
Alpha Fetoprotein ◽  
Early Indicator ◽  
Cirrhotic Patients

Coagulation Assays as Diagnostic Markers of Hepatocellular Carcinoma

1988 ◽  
Vol 60 (03) ◽  
pp. 468-470 ◽  
Author(s):  
J J Lefrère ◽  
J Conard ◽  
P Mavier ◽  
L Bettan ◽  
M Beaugrand ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Prothrombin Time ◽  
Alpha Fetoprotein ◽  
Factor V ◽  
Thrombin Time ◽  
Vitamin K1 ◽  
Normal Value ◽  
Coagulation Assays ◽  
Cirrhotic Patients ◽  
Time Test

SummaryWith the aim of improving the biological diagnosis of hepatocellular carcinoma (HCC), alpha-fetoprotein (AFP), des-gamma-carboxyprothrombin (DCP) and factor V levels were assayed in 119 patients with HCC and 60 cirrhotic patients without HCC. Among the patients with HCC, increased levels of AFP (>300 ng/ml) and of DCP (>15 mU/ml) vveie ubseived in 36% and 69% of the cases, respectively. None of the 60 patients without TTCC had increased AFP, and one had abnormal DCP; in this patient, DCP level returned to normal value after vitamin K1 injection. No significant correlation was found between increased AFP and DCP, thus indicating that the two tests complement each other for the diagnosis. A factor V level higher than expected from the reduced prothrombin time test of the patient was detected in 50% of patients with HCC and only 7% of those without HCC. No correlation was found between increased factor V and abnormal AFP or DCP The thrombin time, fibrinogen activity to antigen ratio, and polymerization index failed to differentiate between cirrhosis and HCC. We conclude that AFP, DCP and factor V may give complementary informations in the diagnosis of HCC, one of these markers at least being positive in 88% of the patients.

Alpha Fetoprotein and a Useful Tool for Surveillance of Interferon-Free Treated Cirrhotic Patients for Hepatocellular Carcinoma After SVR

2017 ◽  
Vol 152 (5) ◽  
pp. S298
Author(s):  
Liana Gheorghe ◽  
Speranta Iacob ◽  
Cristina Cijevschi Prelipcean ◽  
Catalina Mihai ◽  
Mugur Grasu ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Alpha Fetoprotein ◽  
Cirrhotic Patients

scholarly journals FREQUENCY OF HEPATOCELLULAR CARCINOMA IN CIRRHOSIS

2012 ◽  
Vol 19 (01) ◽  
pp. 073-077
Author(s):  
SAID AMIN ◽  
GHULAM SHABBIER ◽  
ANWAR UL HAQ ◽  
Muhammad Noor Wazir
Keyword(s):  
Hepatocellular Carcinoma ◽  
Hepatitis C ◽  
Imaging Modality ◽  
Local Population ◽  
Abdominal Distension ◽  
Alpha Fetoprotein ◽  
Ultra Sound ◽  
Focal Lesion ◽  
History Of ◽  
Cirrhotic Patients

Objective: To find the frequency of hepatocellular carcinoma in cirrhotic patients of our population. Design: Prospectiveobservational study. Setting: Medical A Unit Hayat Abad Medical Complex Peshawar. Period: 1st January 2010 to 31st July 2011. Material &methods: All patients were screened for presence of Hepatocellular carcinoma (HCC) by performing Alpha fetoprotein and ultra sound (U/S)abdomen. Contrast enhanced computed tomography scan (CT) of abdomen was done in selective cases. European Association for the Studyof Liver Diseases (EASLD) Noninvasive criteria (limited to patients with underlying cirrhosis) was used for diagnosis of HCC i.e. Two coincidentimaging techniques that identify a focal lesion more than 2 cm showing arterial hypervascularization or one imaging modality that identifies afocal lesion more than 2 cm in diameter showing arterial hypervascularization and serum AFP levels greater than 400 ng/Ml. Results: A total of370 patients cirrhotic patients were enrolled in this study. Thirty nine patients (10.5%) were diagnosed as having HCC. Male patients were 30(77%) and 9(23%) were female. Mean age was 49.2% (range 18 to 72 years). Abdominal discomfort was predominant symptom present in 94%patients, followed by anorexia present in 90% patients, abdominal distension in 76%, weight loss in 62%, jaundice was present in 46% patients,altered mental status was notice in 36% patients and history of upper gastrointestinal (GI) bleed and malena was extracted from 26% patients.Ultrasound abdomen and CT abdomen showed unifocal lesion in 48.7% patients, multifocal lesion in 30.7% patients and massive lesion in20.5% patients. Alpha fetoprotein ranged from 45ng/dl to 630ng/dl. Hepatitis C (HCV) was the commonest cause present in 51% patients,Hepatitis B (HBV) in 15.3% patients and HBV and HCV co-infection in 10.25% patients, history of alcoholism was revealed in 5% patients and in2.5% patients alcoholism was present along with HCV and HBV each, while in 10% cases the cause of cirrhosis remained unknown.Conclusions: Hepatocellular carcinoma is the most common primary hepatic tumor and one of the most common cancers worldwide. It isconcluded that HCC is more common in males compared to female cirrhotic patients. Hepatitis C followed by HBV are the leading causes ofHCC related cirrhosis in local Population of Khyber pakhtoonkhwa.

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