Feasibility of alpha-fetoprotein as a diagnostic tool for hepatocellular carcinoma in Korea.
10.3904/kjim.2016.31.1.46
- Author:
Dae Geon AHN
1
;
Hyung Joon KIM
;
Hyun KANG
;
Hyun Woong LEE
;
Si Hyun BAE
;
Joon Hyoek LEE
;
Yong Han PAIK
;
June Sung LEE
Author Information
1. Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea. mdjoon@cau.ac.kr
- Publication Type:Evaluation Studies ; Multicenter Study ; Original Article
- Keywords:
Alpha-fetoproteins;
Carcinoma;
Diagnosis;
Hepatocellular
- MeSH:
Aged;
Area Under Curve;
Carcinoma, Hepatocellular/*blood/*diagnosis/pathology;
Feasibility Studies;
Female;
Humans;
Liver Neoplasms/*blood/*diagnosis/pathology;
Male;
Middle Aged;
Neoplasm Staging;
Predictive Value of Tests;
ROC Curve;
Republic of Korea;
Retrospective Studies;
alpha-Fetoproteins/*analysis
- From:The Korean Journal of Internal Medicine
2016;31(1):46-53
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND/AIMS: The aim of this study was to evaluate the feasibility of alpha-fetoprotein (AFP) as a diagnostic tool for hepatocellular carcinoma (HCC) in Korean patients. METHODS: We retrospectively reviewed the medical records of HCC and cirrhosis patients at three hospitals. For each HCC patient, a cirrhosis patient matched for age, sex, etiology, and Child-Pugh classification was selected by simple random sampling. The performance of AFP in the diagnosis of HCC was determined using receiver operating characteristic curve analysis. RESULTS: A total of 732 patients with HCC or cirrhosis were selected for each case and the control groups. The mean age was 54 years, and 72.4% of patients were male. The mean serum AFP levels in the HCC group and cirrhosis group were 3,315.6 and 117.2 ng/mL, respectively (p < 0.001). The area under the receiver operating characteristic curve for all HCC patients was 0.757. The sensitivity, specificity, and positive predictive value of AFP was 50.55%, 87.70%, and 80.43%, respectively, at a cut-off of 20 ng/mL; 37.70%, 95.90%, and 90.20%, respectively, at a cut-off of 100 ng/mL, and 30.05%, 97.27%, and 91.67%, respectively, at a cut-off of 200 ng/mL. A cut-off of 100 ng/mL was more sensitive than one of 200 ng/mL with equivalent specificity and positive predictive value. CONCLUSIONS: The cut-off AFP value for early-stage HCC was 17.4 ng/mL. Our study cautiously suggests that AFP has a role in the diagnosis of HCC, and that the appropriate value of AFP for the diagnosis of HCC may be 100 ng/mL rather than 200 ng/mL.
