HEPATOCELLULAR CARCINOMA (HCC) AND DIAGNOSTIC SIGNIFICANCE OF -FETOPROTEIN (AFP)
Abstract
Background: Alpha-fetoprotein (-fetoprotein, AFP) is a Glycoprotein, belonging to theintriguing class of onco-development protein. Generally designated as tumour marker, AFP isrecognized as an important blood component, having specific diagnostic utilities Elevation ofits level up to pathological range in adults correlate with the appearance of several malignantand chronic conditions, such as hepatocellular carcinoma (HCC) and chronic liver disease,respectively. Methods: To evaluate the diagnostic significance of AFP in HCC, a study wascarried out for a period of two years (Jan 2004 to Dec 2005) A brief history of Patients wastaken with clinical symptoms and signs and initial diagnosis. Patients admitted in wards orvisiting OPDs with diagnosis or suspicions of HCC and additional conditions of ChronicLiver disease (CLDs), hepatitis C (HCV) and hepatitis B viral (HBV) infections, wereselected and classified according to gender. When confirmed, their HCC status was evaluatedand classified according to clinical condition. Results: In 1012 adults including, males 762(75.3%) and females 250 (24.7%) patients suspected of or diagnosed with HCC and presenceof HBV and HCV infections. Out of 480 males, who depicted elevated AFP levels, 39(8.13%) were diagnosed with HCC. Similarly, 7 (5.34%) females out of 131 with elevatedlevels of AFP were diagnosed with HCC. Mean elevated AFP levels in all HCC patients were,42159 µg/ml (range 157–4019 µg/ml) in males and 16332 µg/ml (range 101–2341 µg/ml)in females. In males, the overall estimated mean AFP elevated values were analysed to be 514µg/ml (range 67–4019±59 µg/ml,), whereas in females it was 396±42 µg/ml (range 21–2341µg/ml). It was also noted that 43 (8.96%) males and 7 (5.34%) female patients, exhibitedelevated levels of AFP, however, found negative for HCV and HBV infections. Conclusion:It is concluded that AFP is a significant markers for Hepatocellular carcinoma, helpful inassessing problems in management of HCC and monitoring treatment regiments. In addition,AFP is also an indicator of HCC risks mostly in patients with cirrhosis and HCV/HBVinfectionsKeywords: AFP, Hepatocellular carcinoma HCC, Hepatitis infections HCV, HBVReferences
Gillespie JR, Uversky VN. Structure and function of alphafetoprotein: a biophysical overview. Biochim Biophys Acta
;1480(1–2):41–56.
Abelev GI, Lazarevich NL. Alpha-fetoprotein (AFP): solved
and unsolved problems. McGill J Med 1996;2:127–34.
Brock DJH, Sutcliffe RG. Alpha-fetoprotein in antenatal
diagnosis of anencephaly and spina bifida. Lancet
;300(7770):197–9.
Milunsky A, Alper E. Results and benefits of a maternal
serum alpha-fetoprotein screening program. JAMA
;252:1438–42.
Macias-Rodriguez MA, Rendon-Unceta P, Tejada-Cabrera
M, Infante-Hernandez JM, Correro-Aguilar F, Diaz-Garcia F.
Risk factor for hepatocellular carcinoma with liver cirrhosis.
Rev Esp Enferm Dig 2000;92(7):458–69.
Pompili M, Rapaccini GL, Covino M, Pignataro G, Caturelli
E, Siena, DA, et al. Prognostic factors for survival in patients
with compensated cirrhosis and small hepatocellular
carcinoma after percutaneous ethanol injection therapy.
Cancer 2001;92(1):126–35.
Jones EA, Clement-Jones M, James OF and Wilson DI.
Differences between human and mouse alpha-fetoprotein
expression during early development. J Anat 2001;198:555–9.
Tong MJ, Blatt LM, Kao VM. Surveillance for hepatocellular
carcinoma in patients with chronic viral hepatitis in the
United States of America. J Gastroenterol Hepatol
;16:553–9
Bolondi L, Sofia S, Siringo S, Gaiani S, Casali A, Zironi G,
Piscaglia F, et al. Surveillance program of cirrhotic patients
for early diagnosis and treatment of hepatocellular
carcinoma: a cost effectiveness analysis. Gut 2001;48:251–9.
Cedrone A, Covino M, Caturelli E, Pompilli M, Lorenzelli G,
Villani MR, et al. Utility of alpha-fetoprotein (AFP) in the
screening of patients with virus-related chronic liver disease:
does different viral etiology influence AFP levels in HCC? A
study in 350 western patients. Hepatogastroenterology
;47:1654–8.
Kubicka S, Rudolph KL, Hanke M, Tietze MK, Tillmann
HL, Trautwein C et al. Hepatocellular carcinoma in
Germany, a retrospective epidemiological study from a lowendemic area. Liver 2000;20:312–8.
Toyoda H, Hirai T, Ishii E. Alpha-fetoprotein producing
uterine corpus carcinoma: a hepatoid adenocarcinoma of the
endometrium. Pathol Int 2000;50:847–52.
Johnson PJ, Poon TC, Hjelm NM, Ho CS, Blake C, Ho SK.
Structures of disease-specific serum alpha-fetoprotein
isoforms. Br J Cancer 2000;83:1330–7.
Johnson PJ. The role serum alpha-fetoprotein estimation in
the diagnosis and management of hepatocellular carcinoma.
Clin Liver Dis 2001;5(1):145–59.
Engelhardt NV, Poltoranina, VS, Yazova AK Localization of
alpha-fetoprotein in transplantable murine teratocarcinomas.
Intl J Cancer 1973;11:448–59.
J Ayub Med Coll Abbottabad 2009;21(1)
http://www.ayubmed.edu.pk/JAMC/PAST/21-1/Jawed.pdf 75
Abelev GI, Elgort DA. Alpha-fetoprotein. In: Holland J and
Frei, F. eds. Cancer Medicine, 2nd edition, New York: Lea
and Febiger; 1982. p.1089–99.
Masseyeff R. Alpha-fetoprotein—use in screening. In:
Herberman RB, McIntire KR, eds. Immunodiagnosis of
Cancer, I edition. New York: Marcel Dekker; 1979. p.117–30.
Masseyeff R. Human alpha-fetoprotein. Pathol Biol
;20:703–27.
Di-Carlo A, Mariano A, D’Alessandro V, Belli G, Romano
G, Macchia V. Evaluation of epidermal growth factor
receptor, CEA and Lewis carbohydrate antigen in human
colorectal and liver neoplasias. Oncol Rep 2001;8:387–92.
Sangiovanni A, Colombo E, Radaelli F, Bortoli A, Bova G,
Casraghi MA, et al. Hepatocyte proliferation and risk of
hepatocellular carcinoma in cirrhotic patients. Am J
Gastroenterol. 2001;96:1575–80.
Tang ZY. Hepatocellular carcinoma. J Gastroenterol Hepatol
;15:1–7.
Deutsch HF. Chemistry and biology of alpha-fetoprotein.
Adv Cancer Res 1991;56:253–312.
Chan MH, Shing MM, Poon TC, Johnson PJ, Lam CW.
Alpha-fetoprotein variants in a vase of pancreatoblastoma.
Ann Clin Biochem 2000;37:681–5.
Published
Issue
Section
License
Journal of Ayub Medical College, Abbottabad is an OPEN ACCESS JOURNAL which means that all content is FREELY available without charge to all users whether registered with the journal or not. The work published by J Ayub Med Coll Abbottabad is licensed and distributed under the creative commons License CC BY ND Attribution-NoDerivs. Material printed in this journal is OPEN to access, and are FREE for use in academic and research work with proper citation. J Ayub Med Coll Abbottabad accepts only original material for publication with the understanding that except for abstracts, no part of the data has been published or will be submitted for publication elsewhere before appearing in J Ayub Med Coll Abbottabad. The Editorial Board of J Ayub Med Coll Abbottabad makes every effort to ensure the accuracy and authenticity of material printed in J Ayub Med Coll Abbottabad. However, conclusions and statements expressed are views of the authors and do not reflect the opinion/policy of J Ayub Med Coll Abbottabad or the Editorial Board.
USERS are allowed to read, download, copy, distribute, print, search, or link to the full texts of the articles, or use them for any other lawful purpose, without asking prior permission from the publisher or the author. This is in accordance with the BOAI definition of open access.
AUTHORS retain the rights of free downloading/unlimited e-print of full text and sharing/disseminating the article without any restriction, by any means including twitter, scholarly collaboration networks such as ResearchGate, Academia.eu, and social media sites such as Twitter, LinkedIn, Google Scholar and any other professional or academic networking site.
