Hepatocellular carcinoma (HCC) and diagnostic significance of A-fetoprotein
Li et al., "Diagnostic evaluation of desgamma-carboxy prothrombin versus a-fetoprotein
for hepatitis B virus-related hepatocellular carcinoma in China: a large-scale, multicentre study," PLoS One, vol.
This was significantly reinforced with discovery of a-fetoprotein
(AFP) in amniotic fluid in 1972 and subsequently in the maternal blood in 1973 (13,24) with the significant association of elevated AFP with neural tube defects (anencephaly and spina bifida).
The baseline laboratory tests (normal values in parentheses) yielded the following results: White blood cell count: 10,280 cells/mm [sup] (<10,000); aspartate aminotransferase/alanine aminotransferase: 91/48 IU/L; total bilirubin: 1.4 mg/dL (<1.2); amylase: 124 U/L (<100); lipase: >3,000 U/L (<60); creatinine: 1.3 mg/dL (<1.2); lactic acid: 0.9 mmol/L (<2.2); alkaline phosphate: 95 U/L (<104); a-fetoprotein
: 26 ng/mL (<20); total calcium: 7.5 mg/dL (>8.0); and Ca 19-9: 301 U/mL (<37).
Biopsy is, however, not routine in the work up of HB and HCC, although it is used where there is diagnostic doubt since HB may present similarly to UESL and have low a-fetoprotein
The diagnosis can also be suspected in antenatal period if ultrasonography is normal in presence of the raised a-fetoprotein
level in amniotic fluid and maternal blood or a positive acetyl - cholinesterase test.9 Differential diagnoses
Of the 33 input variables, the following 21 statistically significant variables were retained for constructing ANN models: age, comorbidity, liver cirrhosis, a-Fetoprotein
, AST, total bilirubin, albumin, BUN, platelet, ASA classification, Child-Pugh classification, TNM stage, tumor number, tumor size, portal vein invasion, biliary invasion, surgical procedure, postoperative complication, recurrence, and postoperative treatment.
Tumor markers including carcinoembryonic antigen and carbohydrate antigen 12-5 were within normal limits, except a-fetoprotein
( greater than 1200ng/ml; normal 0-8ng/ml), carbohydrate antigen 19-9 (64.41 U/ml; normal 0-22U/ml).
In April 2000, he had been admitted to urology clinic because of painless left testicular mass and diagnosed as having metastatic testicular embryonal carcinoma with normal beta human chorionic gonadotropin KG) levels and markedly elevated levels of a-fetoprotein
(9204 IU/mL, normal: 0.5-5.0).
Test Characteristics of a-fetoprotein
for detecting hepatocelular carcinoma in patients with Hepatitis C.
Miyagi et al., "a-Fetoprotein
impairs activation of natural killer cells by inhibiting the function of dendritic cells," Clinical & Experimental Immunology, vol.
Age, hepatitis B surface antigen, hepatitis B e antigen, partial thromboplastin time, total bilirubin, alkaline phosphatase, a-glutamyltransferase, a-fetoprotein
, tumor size, cirrhosis, vascular invasion, differentiation, encapsulation, and tumor number were finally retained by a backward step-down selection process with the Akaike information criterion.
Comparative study of three amniotic fluid markers in premature rupture of membranes: prolactin, b subunit of human chorionic gonadotropin, and a-fetoprotein
. Gynecol Obstet Invest 2006; 63: 195-199.
Screening programs for open neural tube defects began in the late 1970s, following documentation that elevated levels of maternal serum a-fetoprotein
(AFP) in the second trimester were associated with open spina bifida and anencephaly.
Currently used screening tools for HCC in patients with cirrhosis include ultrasonography and measurement of a-fetoprotein
(AFP) concentrations in serum at a 6-month interval (4).