Sinn Dong Hyun, Yi Jieun, Choi Moon Seok, Kim Yu Jin, Gwak Geum-Youn, Lee Joon Hyeok, Koh Kwang Cheol, Paik Seung Woon, Yoo Byung Chul
Hepatogastroenterology. 2015 Mar-Apr;62(138):327-32.
BACKGROUND/AIMS: The role of serum alpha-fetoprotein (AFP) determination in hepatocellular carcinoma (HCC) surveillance is controversial.
We reviewed a total of 132 patients (mean age 57.8 ± 9.6, males = 101 (76%); HBsAg positive = 109 (82.6%); cirrhosis = 94 (71.2%)) who were diagnosed with HCC during regular surveillance test with ultrasound (US) and AFP.
The primary mode of tumor detection was US only in 51.5%, US and AFP in 22.0%, AFP only in 19.7%, and incidental in 6.8% of patients. US detected 68.5% of tumor diagnosed at early stage, which was significantly lower than tumor beyond-early stage (85.0%, p = 0.048). AFP doubling (an increase in AFP level more than double from a prior surveillance) was more frequently observed in HBV-related HCC (47.7%) than HCV-related HCC (11.8%, p = 0.009). The AFP increased sensitivity by 19.7% for all patients; 28.0% for HBV-related early stage HCC patients.
This result suggest that serum AFP measurements may have a significant role in increasing sensitivity in HCC surveillance, especially for detecting early stage HBV-related HCC.
背景/目的：血清甲胎蛋白（AFP）检测在肝细胞癌（HCC）监测中的作用存在争议。
我们回顾了总共132例患者（平均年龄57.8±9.6岁，男性101例（76%）；乙肝表面抗原阳性109例（82.6%）；肝硬化94例（71.2%）），这些患者在超声（US）和AFP定期监测检查期间被诊断为HCC。
肿瘤检测的主要方式仅US占51.5%，US和AFP占22.0%，仅AFP占19.7%，偶然发现占6.8%。US检测出68.5%的早期诊断肿瘤，显著低于早期以外阶段的肿瘤（85.0%，p = 0.048）。AFP翻倍（AFP水平较前一次监测增加超过一倍）在乙肝相关HCC（47.7%）中比丙肝相关HCC（11.8%，p = 0.009）中更常见。AFP对所有患者的敏感性提高了19.7%；对乙肝相关早期HCC患者提高了28.0%。
该结果表明血清AFP检测在提高HCC监测敏感性方面可能具有重要作用，特别是对于检测早期乙肝相关HCC。
