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Reappraisal of the diagnostic value of alpha‐fetoprotein for surveillance of HBV‐related hepatocellular carcinoma in the era of antiviral therapy

This study was designed to explore if antiviral treatment influences the performance of serum alpha‐fetoprotein (AFP) for hepatocellular carcinoma (HCC) among the high‐risk chronic HBV‐infected patients. A total of 5936 patients who had evidence of chronic HBV infection were enrolled from four indep...

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Autores principales: Qian, Xiangjun, Liu, Shuhong, Long, Huiling, Zhang, Siyu, Yan, Xiaotong, Yao, Mingjie, Zhou, Jiyuan, Gong, Jiao, Wang, Jianwen, Wen, Xiajie, Zhou, Tao, Zhai, Xiangwei, Xu, Qiang, Zhang, Ting, Chen, Xiangmei, Hu, Guoxin, Wang, Jie, Gao, Zhiliang, Nan, Yuemin, Chen, Junhui, Hu, Bo, Zhao, Jingmin, Lu, Fengmin
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7756791/
https://www.ncbi.nlm.nih.gov/pubmed/32852885
http://dx.doi.org/10.1111/jvh.13388
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author Qian, Xiangjun
Liu, Shuhong
Long, Huiling
Zhang, Siyu
Yan, Xiaotong
Yao, Mingjie
Zhou, Jiyuan
Gong, Jiao
Wang, Jianwen
Wen, Xiajie
Zhou, Tao
Zhai, Xiangwei
Xu, Qiang
Zhang, Ting
Chen, Xiangmei
Hu, Guoxin
Wang, Jie
Gao, Zhiliang
Nan, Yuemin
Chen, Junhui
Hu, Bo
Zhao, Jingmin
Lu, Fengmin
author_facet Qian, Xiangjun
Liu, Shuhong
Long, Huiling
Zhang, Siyu
Yan, Xiaotong
Yao, Mingjie
Zhou, Jiyuan
Gong, Jiao
Wang, Jianwen
Wen, Xiajie
Zhou, Tao
Zhai, Xiangwei
Xu, Qiang
Zhang, Ting
Chen, Xiangmei
Hu, Guoxin
Wang, Jie
Gao, Zhiliang
Nan, Yuemin
Chen, Junhui
Hu, Bo
Zhao, Jingmin
Lu, Fengmin
author_sort Qian, Xiangjun
collection PubMed
description This study was designed to explore if antiviral treatment influences the performance of serum alpha‐fetoprotein (AFP) for hepatocellular carcinoma (HCC) among the high‐risk chronic HBV‐infected patients. A total of 5936 patients who had evidence of chronic HBV infection were enrolled from four independent centres in this retrospective study, including 1721 chronic hepatitis B (CHB), 2286 liver cirrhosis (LC), 798 HCC within Milan criteria and 1131 HCC beyond Milan criteria patients. Stratified by whether they received treatment or not, the patients were further divided into antiviral and non‐antiviral groups. Then, the performance of AFP for discriminating HCC was evaluated. Patients receiving antivirals had significantly lower median levels of AFP compared with the non‐antiviral patients (P < .001), and there were significantly less patients with abnormal AFP levels in antiviral groups (P < .001). Antiviral therapy improved the AUROCs of AFP for discriminating HCC within Milan criteria. When setting the cut‐off values at 20 ng/mL and 100 ng/mL as surveillance and confirmatory tests respectively for HCC among patients receiving antiviral treatment, AFP exhibited a significantly higher sensitivity than those of 200 ng/mL and 400 ng/mL, which are currently recommended by some guidelines, without compromising specificity. Further analysis in antiviral patients revealed that serum AFP had better performance for discriminating HCC within Milan criteria in ALT ≤ 1ULN patients than that in ALT > 1ULN patients. In conclusion, in the era of antiviral therapy, serum AFP's surveillance performance was substantially improved for HCC within Milan criteria among the high‐risk population of CHB and LC patients.
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spelling pubmed-77567912020-12-28 Reappraisal of the diagnostic value of alpha‐fetoprotein for surveillance of HBV‐related hepatocellular carcinoma in the era of antiviral therapy Qian, Xiangjun Liu, Shuhong Long, Huiling Zhang, Siyu Yan, Xiaotong Yao, Mingjie Zhou, Jiyuan Gong, Jiao Wang, Jianwen Wen, Xiajie Zhou, Tao Zhai, Xiangwei Xu, Qiang Zhang, Ting Chen, Xiangmei Hu, Guoxin Wang, Jie Gao, Zhiliang Nan, Yuemin Chen, Junhui Hu, Bo Zhao, Jingmin Lu, Fengmin J Viral Hepat Original Articles This study was designed to explore if antiviral treatment influences the performance of serum alpha‐fetoprotein (AFP) for hepatocellular carcinoma (HCC) among the high‐risk chronic HBV‐infected patients. A total of 5936 patients who had evidence of chronic HBV infection were enrolled from four independent centres in this retrospective study, including 1721 chronic hepatitis B (CHB), 2286 liver cirrhosis (LC), 798 HCC within Milan criteria and 1131 HCC beyond Milan criteria patients. Stratified by whether they received treatment or not, the patients were further divided into antiviral and non‐antiviral groups. Then, the performance of AFP for discriminating HCC was evaluated. Patients receiving antivirals had significantly lower median levels of AFP compared with the non‐antiviral patients (P < .001), and there were significantly less patients with abnormal AFP levels in antiviral groups (P < .001). Antiviral therapy improved the AUROCs of AFP for discriminating HCC within Milan criteria. When setting the cut‐off values at 20 ng/mL and 100 ng/mL as surveillance and confirmatory tests respectively for HCC among patients receiving antiviral treatment, AFP exhibited a significantly higher sensitivity than those of 200 ng/mL and 400 ng/mL, which are currently recommended by some guidelines, without compromising specificity. Further analysis in antiviral patients revealed that serum AFP had better performance for discriminating HCC within Milan criteria in ALT ≤ 1ULN patients than that in ALT > 1ULN patients. In conclusion, in the era of antiviral therapy, serum AFP's surveillance performance was substantially improved for HCC within Milan criteria among the high‐risk population of CHB and LC patients. John Wiley and Sons Inc. 2020-09-22 2021-01 /pmc/articles/PMC7756791/ /pubmed/32852885 http://dx.doi.org/10.1111/jvh.13388 Text en © 2020 The Authors. Journal of Viral Hepatitis published by John Wiley & Sons Ltd This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.
spellingShingle Original Articles
Qian, Xiangjun
Liu, Shuhong
Long, Huiling
Zhang, Siyu
Yan, Xiaotong
Yao, Mingjie
Zhou, Jiyuan
Gong, Jiao
Wang, Jianwen
Wen, Xiajie
Zhou, Tao
Zhai, Xiangwei
Xu, Qiang
Zhang, Ting
Chen, Xiangmei
Hu, Guoxin
Wang, Jie
Gao, Zhiliang
Nan, Yuemin
Chen, Junhui
Hu, Bo
Zhao, Jingmin
Lu, Fengmin
Reappraisal of the diagnostic value of alpha‐fetoprotein for surveillance of HBV‐related hepatocellular carcinoma in the era of antiviral therapy
title Reappraisal of the diagnostic value of alpha‐fetoprotein for surveillance of HBV‐related hepatocellular carcinoma in the era of antiviral therapy
title_full Reappraisal of the diagnostic value of alpha‐fetoprotein for surveillance of HBV‐related hepatocellular carcinoma in the era of antiviral therapy
title_fullStr Reappraisal of the diagnostic value of alpha‐fetoprotein for surveillance of HBV‐related hepatocellular carcinoma in the era of antiviral therapy
title_full_unstemmed Reappraisal of the diagnostic value of alpha‐fetoprotein for surveillance of HBV‐related hepatocellular carcinoma in the era of antiviral therapy
title_short Reappraisal of the diagnostic value of alpha‐fetoprotein for surveillance of HBV‐related hepatocellular carcinoma in the era of antiviral therapy
title_sort reappraisal of the diagnostic value of alpha‐fetoprotein for surveillance of hbv‐related hepatocellular carcinoma in the era of antiviral therapy
topic Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7756791/
https://www.ncbi.nlm.nih.gov/pubmed/32852885
http://dx.doi.org/10.1111/jvh.13388
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