Feasibility of alpha-fetoprotein as a diagnostic tool for hepatocellular carcinoma in Korea
- Authors
- Ahn, Dae Geon; Kim, Hyung Joon; Kang, Hyun; Lee, Hyun Woong; Bae, Si Hyun; Lee, Joon Hyoek; Paik, Yong Han; Lee, June Sung
- Issue Date
- Jan-2016
- Publisher
- KOREAN ASSOC INTERNAL MEDICINE
- Keywords
- Alpha-fetoproteins; Carcinoma; Diagnosis; Hepatocellular
- Citation
- KOREAN JOURNAL OF INTERNAL MEDICINE, v.31, no.1, pp 46 - 53
- Pages
- 8
- Journal Title
- KOREAN JOURNAL OF INTERNAL MEDICINE
- Volume
- 31
- Number
- 1
- Start Page
- 46
- End Page
- 53
- URI
- https://scholarworks.bwise.kr/cau/handle/2019.sw.cau/7406
- DOI
- 10.3904/kjim.2016.31.1.46
- ISSN
- 1226-3303
2005-6648
- Abstract
- Background/Aims: The aim of this study was to evaluate the feasibility of a-fetoprotein (AFP) as a diagnostic tool for hepatocellular carcinoma (HCC) in Korean patients. Methods: We retrospectively reviewed the medical records of HCC and cirrhosis patients at three hospitals. For each HCC patient, a cirrhosis patient matched for age, sex, etiology, and Child-Pugh classification was selected by simple random sampling. The performance of AFP in the diagnosis of HCC was determined using receiver operating characteristic curve analysis. Results: A total of 732 patients with HCC or cirrhosis were selected for each case and the control groups. The mean age was 54 years, and 72.4% of patients were male. The mean serum AFP levels in the HCC group and cirrhosis group were 3,315.6 and 117.2 ng/mL, respectively (p < 0.001). The area under the receiver operating characteristic curve for all HCC patients was 0.757. The sensitivity, specificity, and positive predictive value of AFP was 50.55%, 87.70%, and 80.43%, respectively, at a cut-off of 20 ng/mL; 37.70%, 95.90%, and 90.20%, respectively, at a cutoff of 100 ng/mL, and 30.05%, 97.27%, and 91.67%, respectively, at a cut-off of 200 ng/mL. A cut-off of 100 ng/mL was more sensitive than one of 200 ng/mL with equivalent specificity and positive predictive value. Conclusions: The cut-off AFP value for early-stage HCC was 17.4 ng/mL. Our study cautiously suggests that AFP has a role in the diagnosis of HCC, and that the appropriate value of AFP for the diagnosis of HCC may be 100 ng/mL rather than 200 ng/mL.
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