Simultaneous breast cancer and hepatocellular carcinoma in a male patient with alcoholic liver cirrhosis and a normal serum alpha-fetoprotein level

We investigated the feasibility of the combined detection of HLA-A2/MAGE-A3 epitope-specific cytotoxic T lymphocytes (CTLs) and serum alpha-fetoprotein (AFP) for specific diagnosis of hepatocellular carcinoma (HCC). We detected the frequency of MAGE-A3 epitopes (p112–120, KVAELVHFL) in spontaneous CTLs in the peripheral blood of HCC patients, liver cirrhosis patients, and healthy subjects with HLA-A2/polypeptide complex (pentamer) detection technology. Eighty-five HCC cases, 38 liver cirrhosis cases, and 50 healthy cases who were HLA-A2-positive were selected from 175 HCC patients, 80 patients with liver cirrhosis, and 105 healthy volunteers, respectively. The frequency of HLA-A2-specific MAGE-A3+CTLs in the HCC group was significantly higher than that in the other groups. Combined detection of MAGE-A3+CTL frequency and serum AFP value had a higher specificity than either of the two indicators alone. The pentamer technique is helpful in distinguishing benign lesions and malignant lesions in the liver. Combined with serum AFP, it can improve the diagnosis performance for HCC, especially for AFP-negative cancer.

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A retrospective study on the patterns of sequential fluctuation of serum alpha-fetoprotein level during progression from liver cirrhosis to hepatocellular carcinoma

Journal of Gastroenterology and Hepatology ◽

10.1111/j.1440-1746.1992.tb00949.x ◽

1992 ◽

Vol 7 (2) ◽

pp. 132-135 ◽

Cited By ~ 7

Author(s):

TAKEYOSHI IMAEDA ◽

HIDETAKA DOI

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Cirrhosis ◽

Retrospective Study ◽

Alpha Fetoprotein ◽

Serum Alpha Fetoprotein

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Extreme Elevation of Serum Alpha Fetoprotein in Decompensated Cirrhosis without Hcc: an Ominous Sign

The International Journal of Biological Markers ◽

10.1177/172460080702200103 ◽

2007 ◽

Vol 22 (1) ◽

pp. 19-23

Author(s):

H. Senturk ◽

R. Cumali

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Transplantation ◽

Liver Cirrhosis ◽

Liver Failure ◽

Alpha Fetoprotein ◽

Decompensated Cirrhosis ◽

Serum Alpha Fetoprotein

Three cases of extreme elevation of serum alpha fetoprotein (>10,000 ng/mL) with decompensated cirrhosis without demonstrable hepatocellular carcinoma are reported. While 2 patients died of liver failure, 1 survived after liver transplantation. Extreme elevation of alpha fetoprotein not associated with hepatocellular carcinoma in liver cirrhosis heralds an ominous prognosis necessitating urgent liver transplantation.

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Usefulness of Circulating Methylated p16 as a Noninvasive Molecular Biomarker for Hepatitis C-Related Hepatocellular Carcinoma with Normal Serum Alpha-Fetoprotein Levels

International Journal of General Medicine ◽

10.2147/ijgm.s249272 ◽

2020 ◽

Vol Volume 13 ◽

pp. 147-155

Author(s):

Wael Abd Elgwad Elsewify ◽

Elham Ahmed Hassan ◽

Mohamed A Mekky ◽

Abeer Sharaf El-Din Abd El-Rehim ◽

Zain El-Abdeen Ahmed Sayed ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Hepatitis C ◽

Normal Serum ◽

Alpha Fetoprotein ◽

Molecular Biomarker ◽

Serum Alpha Fetoprotein

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Pattern Analysis of Serum alpha-fetoprotein in the Early Diagnosis of Hepatocellular Carcinoma in Liver Cirrhosis

The International Journal of Biological Markers ◽

10.1177/172460088800300305 ◽

1988 ◽

Vol 3 (3) ◽

pp. 172-176 ◽

Cited By ~ 8

Author(s):

A. Arrigoni ◽

A. Andriulli ◽

T. Gindro ◽

P. Piantino ◽

L. Capussotti ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Cirrhosis ◽

Liver Tumors ◽

Alpha Fetoprotein ◽

Cutoff Point ◽

Surveillance Program ◽

Unique Role ◽

Early Expression ◽

Serum Alpha Fetoprotein

In a surveillance program for hepatocellular carcinoma (HCC), serum alpha-fetoprotein (AFP) was determined every 4 months in 164 patients with liver cirrhosis. Ultrasonography (US) was performed yearly or as dictated by abnormal AFP levels. During a follow-up of 32.5 ± 20.8 months HCC was identified by US in 16 patients. In 9 of them the AFP levels rose steadily over 4 months, increasing 7, 8 and 12 months in 3 cases before the lesion became detectable by US. In 4 patients tumors developed despite persistently normal AFP levels. Nine more patients showed abnormal fluctuations of AFP but HCC was not detected. AFP sensitivity was higher at a low cutoff point (40 ng/ml) while specificity of the test appeared higher at the 200 ng/ml cutoff point. An AFP value rising steeply over a few months appeared more reliable than a fixed preset threshold in indicating carcinomatous transformation. Screening for AFP can be expected to uncover about 3/4 of HCC developing in cirrhotics with few false-positive reactions. The test may have a unique role in identifying a subset of liver tumors whose early expression is AFP production.

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Clinical Utility of Alpha Fetoprotein and HCCR-1, Alone or in Combination, in Patients with Chronic Hepatitis, Liver Cirrhosis and Hepatocellular Carcinoma

Disease Markers ◽

10.1155/2011/698975 ◽

2011 ◽

Vol 30 (6) ◽

pp. 307-315 ◽

Cited By ~ 7

Author(s):

Peng Jirun ◽

Guoxin Zhang ◽

Hyun Kee Kim ◽

Seon-Ah Ha ◽

Jin Zhongtian ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Liver Cirrhosis ◽

Chronic Hepatitis ◽

Normal Subjects ◽

Alpha Fetoprotein ◽

Combined Use ◽

Significant Difference ◽

Serum Alpha Fetoprotein ◽

Immunohistochemical Studies ◽

A Prospective Study

Serum alpha fetoprotein (AFP) is the most widely used tumor marker in detecting patients with hepatocellular carcinoma (HCC). However, it has been indicated that HCCR-1 (human cervical cancer oncogene 1) might be supplementary to AFP in the detection. We conducted a prospective study in 120 normal and 524 liver disease patients to evaluate the significance of simultaneous measurement of 2 tumor markers (AFP and HCCR-1) in the diagnosis of HCC through the cohort study in Korea and China. We also performed immunohistochemical studies using 25 normal subjects (N), 32 liver cirrhosis (LC) and 116 HCC tissues. The sensitivities of AFP (20 ng/mL) and HCCR-1 (10 ng/mL) in HCC were 55.8% (164/294) and 44.2% (130/294), respectively. When AFP was combined with HCCR-1, sensitivities increased to 4.2% (N), 12.7% (chronic hepatitis; CH), 50.0% (LC), and 77.2% (HCC), respectively. Although there was no significant difference in the diagnostic rate for HCC between AFP and HCCR-1, many cases for AFP-negative HCC were positive for HCCR-1 and vice versa. Moreover, the combined use of AFP and HCCR-1 improved the diagnostic rate to 70.8% in small HCC (< 2 cm) and 81.6% in large HCC (≥ 2 cm), respectively. AFP and HCCR-1 are independent markers. Our result suggests that the HCCR-1 could be an useful biomarker for HCC while the diagnostic rate could be significantly improved in the combined use of HCCR-1 and AFP.

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