skip to main content
Language:
Search Limited to: Search Limited to: Resource type Show Results with: Show Results with: Search type Index

A new approach to the use of α-fetoprotein as surveillance test for hepatocellular carcinoma in patients with cirrhosis

British journal of cancer, 2015-01, Vol.112 (1), p.69-76 [Peer Reviewed Journal]

Copyright © 2015 Cancer Research UK 2015 Cancer Research UK ;ISSN: 0007-0920 ;EISSN: 1532-1827 ;DOI: 10.1038/bjc.2014.536 ;PMID: 25314061

Full text available

Citations Cited by
  • Title:
    A new approach to the use of α-fetoprotein as surveillance test for hepatocellular carcinoma in patients with cirrhosis
  • Author: Biselli, M ; Conti, F ; Gramenzi, A ; Frigerio, M ; Cucchetti, A ; Fatti, G ; D'Angelo, M ; Dall'Agata, M ; Giannini, E G ; Farinati, F ; Ciccarese, F ; Andreone, P ; Bernardi, M ; Trevisani, F
  • Subjects: Adult ; Aged ; Aged, 80 and over ; alpha-Fetoproteins - analysis ; Carcinoma, Hepatocellular - chemistry ; Carcinoma, Hepatocellular - diagnosis ; Case-Control Studies ; Clinical Study ; Female ; Humans ; Liver Cirrhosis - diagnosis ; Liver Neoplasms - chemistry ; Liver Neoplasms - diagnosis ; Male ; Middle Aged ; Prospective Studies ; Retrospective Studies
  • Is Part Of: British journal of cancer, 2015-01, Vol.112 (1), p.69-76
  • Description: Surveillance for hepatocellular carcinoma (HCC) is recommended in patients with cirrhosis. As α-fetoprotein (AFP) is considered a poor surveillance test, we tested the performance of its changes over time. Eighty patients were diagnosed with HCC (cases) during semiannual surveillance with ultrasonography and AFP measurement were recruited and matched for age, gender, etiology and Child-Pugh class with 160 contemporary cancer-free controls undergoing the same surveillance training group (TG). As a validation group (VG) we considered 36 subsequent patients diagnosed with HCC, matched 1 : 3 with contemporary cancer-free controls. α-Fetoprotein values at the time of HCC diagnosis (T0) and its changes over the 12 (Δ12) and 6 months (Δ6) before cancer detection were considered. In both TG and VG, >80% of HCCs were found at an early stage. In TG, AFP significantly increased over time only in cases. T0 AFP and a positive Δ6 were independently associated with HCC diagnosis (odds ratio: 1.031 and 2.402, respectively). The area under the curve of T0 AFP was 0.76 and its best cutoff (BC) was 10 ng ml(-1) (sensitivity 66.3%, specificity 80.6%). The combination of AFP >10 ng ml(-1) or a positive Δ6 composite α-fetoprotein index (CAI) increased the sensitivity to 80% with a negative predictive value (NPV) of 86.2%. Negative predictive value rose to 99%, considering a cancer prevalence of 3%. In the VG, the AFP-BC was again 10 ng ml(-1) (sensitivity 66.7%, specificity 88.9%), and CAI sensitivity was 80.6% with a NPV value of 90.5%. CAI achieves adequate sensitivity and NPV as a surveillance test for the early detection of HCC in cirrhosis.
  • Publisher: England: Nature Publishing Group
  • Language: English
  • Identifier: ISSN: 0007-0920
    EISSN: 1532-1827
    DOI: 10.1038/bjc.2014.536
    PMID: 25314061
  • Source: Open Access: PubMed Central
    Geneva Foundation Free Medical Journals at publisher websites
    AUTh Library subscriptions: ProQuest Central
    MEDLINE
Back to results list
INSPIRE LIBRARY - TON DUC THANG UNIVERSITY (84-028) 37 755 057 Feedback
19 Nguyen Huu Tho St. Dist.7, HCM thuvien@tdtu.edu.vn

Copyright © 2017 INSPIRE LIBRARY - TON DUC THANG UNIVERSITY

Searching Remote Databases, Please Wait