Cargando…

Alpha-Fetoprotein (AFP) and AFP-L3 Is Most Useful in Detection of Recurrence of Hepatocellular Carcinoma in Patients after Tumor Ablation and with Low AFP Level

Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and is a leading cause of mortality worldwide. While there are many risk factors for HCC including alcohol, obesity, and diabetes, hepatitis B virus (HBV) and hepatitis C virus (HCV) infection still account for the maj...

Descripción completa

Detalles Bibliográficos
Autores principales: Force, Madison, Park, Grace, Chalikonda, Divya, Roth, Christopher, Cohen, Micah, Halegoua-DeMarzio, Dina, Hann, Hie-Won
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031551/
https://www.ncbi.nlm.nih.gov/pubmed/35458505
http://dx.doi.org/10.3390/v14040775
_version_ 1784692417898741760
author Force, Madison
Park, Grace
Chalikonda, Divya
Roth, Christopher
Cohen, Micah
Halegoua-DeMarzio, Dina
Hann, Hie-Won
author_facet Force, Madison
Park, Grace
Chalikonda, Divya
Roth, Christopher
Cohen, Micah
Halegoua-DeMarzio, Dina
Hann, Hie-Won
author_sort Force, Madison
collection PubMed
description Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and is a leading cause of mortality worldwide. While there are many risk factors for HCC including alcohol, obesity, and diabetes, hepatitis B virus (HBV) and hepatitis C virus (HCV) infection still account for the majority of HCC worldwide. Globally, HBV is the leading risk factor for HCC. Patients with chronic hepatitis B (CHB) and advanced liver disease are at high risk for HCC. Screening for HCC is done routinely with ultrasound with or without alpha-fetoprotein (AFP) at six-month intervals. The combination of ultrasound and AFP has been shown to provide some additional detection of 6–8% of cases compared to ultrasound alone; however, this also increases false-positive results. This is because AFP can be elevated not only in the setting of HCC, but also in chronic hepatitis, liver cirrhosis, or ALT flare in CHB, which limits the specificity of AFP. AFP-L3 is a subfraction of AFP that is produced by malignant hepatocytes. The ratio of AFP-L3 to total AFP is reported as a percentage, and over 10% AFP-L3 is consistent with a diagnosis of HCC. Here, we review five cases of patients with CHB, cirrhosis, and HCC, and their levels of AFP and the AFP-L3% at various stages of disease including ALT flare, cirrhosis, initial diagnosis of HCC, and recurrence of HCC. These cases emphasize the utility of AFP-L3% in identifying early, new or recurrent HCC prior to the presence of imaging findings.
format Online
Article
Text
id pubmed-9031551
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-90315512022-04-23 Alpha-Fetoprotein (AFP) and AFP-L3 Is Most Useful in Detection of Recurrence of Hepatocellular Carcinoma in Patients after Tumor Ablation and with Low AFP Level Force, Madison Park, Grace Chalikonda, Divya Roth, Christopher Cohen, Micah Halegoua-DeMarzio, Dina Hann, Hie-Won Viruses Case Report Hepatocellular carcinoma (HCC) is the most common primary malignancy of the liver and is a leading cause of mortality worldwide. While there are many risk factors for HCC including alcohol, obesity, and diabetes, hepatitis B virus (HBV) and hepatitis C virus (HCV) infection still account for the majority of HCC worldwide. Globally, HBV is the leading risk factor for HCC. Patients with chronic hepatitis B (CHB) and advanced liver disease are at high risk for HCC. Screening for HCC is done routinely with ultrasound with or without alpha-fetoprotein (AFP) at six-month intervals. The combination of ultrasound and AFP has been shown to provide some additional detection of 6–8% of cases compared to ultrasound alone; however, this also increases false-positive results. This is because AFP can be elevated not only in the setting of HCC, but also in chronic hepatitis, liver cirrhosis, or ALT flare in CHB, which limits the specificity of AFP. AFP-L3 is a subfraction of AFP that is produced by malignant hepatocytes. The ratio of AFP-L3 to total AFP is reported as a percentage, and over 10% AFP-L3 is consistent with a diagnosis of HCC. Here, we review five cases of patients with CHB, cirrhosis, and HCC, and their levels of AFP and the AFP-L3% at various stages of disease including ALT flare, cirrhosis, initial diagnosis of HCC, and recurrence of HCC. These cases emphasize the utility of AFP-L3% in identifying early, new or recurrent HCC prior to the presence of imaging findings. MDPI 2022-04-08 /pmc/articles/PMC9031551/ /pubmed/35458505 http://dx.doi.org/10.3390/v14040775 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Force, Madison
Park, Grace
Chalikonda, Divya
Roth, Christopher
Cohen, Micah
Halegoua-DeMarzio, Dina
Hann, Hie-Won
Alpha-Fetoprotein (AFP) and AFP-L3 Is Most Useful in Detection of Recurrence of Hepatocellular Carcinoma in Patients after Tumor Ablation and with Low AFP Level
title Alpha-Fetoprotein (AFP) and AFP-L3 Is Most Useful in Detection of Recurrence of Hepatocellular Carcinoma in Patients after Tumor Ablation and with Low AFP Level
title_full Alpha-Fetoprotein (AFP) and AFP-L3 Is Most Useful in Detection of Recurrence of Hepatocellular Carcinoma in Patients after Tumor Ablation and with Low AFP Level
title_fullStr Alpha-Fetoprotein (AFP) and AFP-L3 Is Most Useful in Detection of Recurrence of Hepatocellular Carcinoma in Patients after Tumor Ablation and with Low AFP Level
title_full_unstemmed Alpha-Fetoprotein (AFP) and AFP-L3 Is Most Useful in Detection of Recurrence of Hepatocellular Carcinoma in Patients after Tumor Ablation and with Low AFP Level
title_short Alpha-Fetoprotein (AFP) and AFP-L3 Is Most Useful in Detection of Recurrence of Hepatocellular Carcinoma in Patients after Tumor Ablation and with Low AFP Level
title_sort alpha-fetoprotein (afp) and afp-l3 is most useful in detection of recurrence of hepatocellular carcinoma in patients after tumor ablation and with low afp level
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9031551/
https://www.ncbi.nlm.nih.gov/pubmed/35458505
http://dx.doi.org/10.3390/v14040775
work_keys_str_mv AT forcemadison alphafetoproteinafpandafpl3ismostusefulindetectionofrecurrenceofhepatocellularcarcinomainpatientsaftertumorablationandwithlowafplevel
AT parkgrace alphafetoproteinafpandafpl3ismostusefulindetectionofrecurrenceofhepatocellularcarcinomainpatientsaftertumorablationandwithlowafplevel
AT chalikondadivya alphafetoproteinafpandafpl3ismostusefulindetectionofrecurrenceofhepatocellularcarcinomainpatientsaftertumorablationandwithlowafplevel
AT rothchristopher alphafetoproteinafpandafpl3ismostusefulindetectionofrecurrenceofhepatocellularcarcinomainpatientsaftertumorablationandwithlowafplevel
AT cohenmicah alphafetoproteinafpandafpl3ismostusefulindetectionofrecurrenceofhepatocellularcarcinomainpatientsaftertumorablationandwithlowafplevel
AT halegouademarziodina alphafetoproteinafpandafpl3ismostusefulindetectionofrecurrenceofhepatocellularcarcinomainpatientsaftertumorablationandwithlowafplevel
AT hannhiewon alphafetoproteinafpandafpl3ismostusefulindetectionofrecurrenceofhepatocellularcarcinomainpatientsaftertumorablationandwithlowafplevel