Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Germinoma ; blood ; therapy ; Humans ; Infant ; Male ; alpha-Fetoproteins ; analysis

Female ; Humans ; Immunosuppressive Agents ; therapeutic use ; Middle Aged ; Sjogren's Syndrome ; blood ; drug therapy ; alpha-Fetoproteins ; analysis

Biomarkers, Tumor ; blood ; Carcinoma, Hepatocellular ; diagnosis ; Humans ; Liver Neoplasms ; diagnosis ; RNA, Messenger ; blood ; alpha-Fetoproteins ; analysis

BACKGROUND/AIMS: α-Fetoprotein (AFP) is normally <10 ng/mL in adults without malignancy or liver regeneration. However, hereditary or nonhereditary persistence of AFP in healthy adults may be encountered in clinical practice. This study describes four cases of persistent AFP elevation in healthy adults and investigates mutations in key transcription regulatory regions of the AFP gene as potential drivers of AFP overexpression. METHODS: Four healthy adults with persistently elevated AFP levels (12.1 to 186.1 ng/mL) for >1 year, and 20 controls with low AFP levels (<0.61 to 2.9 ng/mL) were included in the study. AFP levels were collected from the families of two of the patients. We sequenced five regions that are critical for AFP expression: a promoter, two enhancers, and two silencers. RESULTS: One of the two cases in which family information was represented is the first case of hereditary persistence of AFP in South Korea. Mutations related to AFP overexpression were not found in the transcription regulatory regions among the four patients. CONCLUSIONS: Persistent AFP elevation is a heterogeneous condition with or without a hereditary pattern and may be caused by factors outside of transcription regulatory region changes. Further research on the mechanism of AFP elevation is needed.
Adult* ; alpha-Fetoproteins ; Biomarkers ; DNA Mutational Analysis ; Humans ; Korea ; Liver Regeneration ; Regulatory Sequences, Nucleic Acid

No abstract available.
*Algorithms ; Automation ; Clinical Laboratory Information Systems/*standards ; Humans ; Immunoassay/*methods ; Indicator Dilution Techniques ; alpha-Fetoproteins/*analysis

PURPOSE: We evaluated oral metronomic capecitabine (MC) compared to intravenous doxorubicin in patients with advanced or metastatic hepatocellular carcinoma (HCC).METHODS: From January 2013 to December 2015, patients with Child-Pugh class A or early B were randomized either to MC group (500 mg twice daily continuously) or doxorubicin group (60 mg/m² every 21 days).RESULTS: Forty patients were included in each group. The baseline clinical characteristics of the enrolled patients were well balanced between the two groups. No complete response (CR) was reported in either group. In MC group, 2 patients (5%) had partial response (PR), 25 patients (62.5%) stable disease (SD) and 27 patients (67.5%) had disease control. In doxorubicin group, 4 patients (10%) achieved PR, 24 patients (60%) SD and 28 patients (70%) had disease control. The 6 months overall survival (OS) was 77.5% for MC and 75% for doxorubicin. The one year OS was 47.5% for MC and 42.5% for doxorubicin (P=0.521). The median OS survival was 10.2 months for MC and 9.6 months for doxorubicin (95% confidence interval, 3.2–6.5). The 6 month progression-free survival (PFS) was 45% for MC and 50% for doxorubicin. The one year PFS was 12.5% for MC and 7.5% for doxorubicin (P=0.289). The median time to progression was 3.4 months for MC and 3.1 months for doxorubicin. On multivariate analysis no significant impact for tumor stage, previous transhepatic arterial chemoembolization, portal vein thrombosis or median baseline alpha fetoprotein on OS.CONCLUSION: MC showed response rate and survival outcome comparable to doxorubicin in advanced HCC but with a more favorable toxicity profile.
alpha-Fetoproteins ; Capecitabine ; Carcinoma, Hepatocellular ; Disease-Free Survival ; Doxorubicin ; Humans ; Multivariate Analysis ; Venous Thrombosis

We report herein a case of 72-year-old woman in whom liver metastasis of colon cancer was presented with a marked elevation of serum alpha-fetoprotein (AFP) level. She was transferred to our hospital for multiple liver masses found on ultrasonogram. Abdominal computed tomogram revealed multiple low-density masses in the liver and wall thickening of the hepatic flexure of colon. The serum AFP level was 10,718.8 ng/mL. Colonoscopic findings of ulcerofungating mass suggested liver metastasis from colon cancer. However, the possibility of combined hepatocellular carcinoma could not be ruled out due to serum AFP elevation. Both colon and liver biopsies revealed moderately differentiated tubular adenocarcinoma. Using an immunohistochemical staining, the adenocarcinoma in liver showed focal positive to AFP, but not in colon. This case represents a very rare case of colon cancer with a marked elevation of serum AFP.
Aged ; Colonic Neoplasms/*pathology ; Female ; Humans ; Liver Neoplasms/*diagnosis/radiography/*secondary ; Tomography, X-Ray Computed ; alpha-Fetoproteins/*analysis

OBJECTIVETo establish the median of serum markers for second trimester screening in Qingdao region and to assess the influence of median correction on the performance of screening.

METHODSMaternal serum alpha-fetoproteins (AFP), human chorionic gonadotrophin, free beta subunit (β -HCG) and unconjugated oestriol (uE3) were assayed for prenatal screening of 18 188 singleton pregnancies at 15-20(+ 6) weeks gestation from January 2009 to July 2010. The median of serum markers was calculated based on above results and applied for risk estimation in screening for fetal aneuploidy from August 2010 to March 2011. The screening performance, specified in terms of detection rates (DRs), false positive rates (FPRs) and odds of being affected given a positive result (OAPR) were compared between the two groups. The risks of 45 affected pregnancies detected during the study were estimated with both Caucasian and corrected medians.

RESULTSThe average level of AFP in local pregnancies was similar to that of the Caucasian population, whilst β -HCG and uE3 were respectively 11% and 33% higher than those of Caucasians. The multiple of median (MoM) value was between 0.94 and 1.02 for the dataset based on the corrected median. At a cut-off of l in 270, FPR has decreased from 5.2% to 4.9%, and DR of Down syndrome has increased from 60% to 69.2%, and OAPR has increased from 1:79 to 1:59 when evaluating risk based on the corrected median. For the 45 affected pregnancies, three Down syndrome pregnancies could be missed because their risk estimates were lower than the cut-off level based on Caucasian median.

CONCLUSIONIt is useful to establish and apply population and laboratory-specific medians in order to improve the performance of prenatal screening and diagnosis.

Adult ; Biomarkers ; blood ; Estriol ; blood ; Female ; Humans ; Lindane ; blood ; Pregnancy ; Pregnancy Trimester, Second ; Prenatal Diagnosis ; methods ; alpha-Fetoproteins ; analysis

BACKGROUNDThe second-trimester maternal serum screening in twin pregnancy is still controversial, as the serum marker levels in twins are not as clear as those in singletons. This study aimed to evaluate the relationship between the levels of the second-trimester maternal serum free beta-human chorionic gonadotropin (free beta-HCG) and alpha-fetoprotein (AFP) in normal twin and singleton pregnancies and to estimate feasible analysis methods for utilizing these markers in second trimester screening for twin pregnancy.

METHODSOn the basis of a prospective population-based study of second-trimester maternal serum screening, the concentrations of maternal serum AFP and free beta-HCG of 195 normal twin pregnancy and 26,512 singleton controls at gestational weeks 15 to 20 were measured by time-resolved fluoroimmunoassay in one laboratory. The levels of markers were compared between the twins and singletons using weight-correction and gestational age-specific model.

RESULTSAccording to the research protocol, 95 communities were randomly sampled, which covered the whole Jiangsu province, the east of China. A total of 26 803 pregnant women (98%), from the target population accepted prenatal screening for maternal serum AFP, beta-HCG detection, and all babies were followed up for at least six months. There were 197 (0.73%) twin pregnancies, of which one case had fetal trisomy 18, and one case with fetal anencephaly. The others were normal twin pregnancy. From a total enrollment of 26 803 women participants, 26 512 women with normal singleton pregnancies were selected as the model controls. The other 291 pregnancies, including trisomy 21, neural tube defect (NTD), trisomy 18, and other fetal abnormalities, were excluded. No significant differences were found in the medians of gestational age-specific maternal serum free beta-hCG and AFP in normal twin pregnancy comparing with twice those in model controls with the exception of the medians for free beta-hCG during the 16th gestational week (P = 0.012).

CONCLUSIONThe weight-correction and gestational age-specific levels of Chinese Han population maternal serum free beta-hCG and AFP in normal twins were twice the levels as those in the singleton controls during the 17-19 gestational weeks.

Adult ; Chorionic Gonadotropin, beta Subunit, Human ; blood ; Female ; Humans ; Pregnancy ; blood ; Pregnancy Trimester, Second ; Twins ; alpha-Fetoproteins ; analysis

Granuloma, Plasma Cell ; blood ; pathology ; surgery ; Humans ; Liver Diseases ; blood ; pathology ; surgery ; Male ; Middle Aged ; alpha-Fetoproteins ; analysis