Alpha-fetoprotein expression in hepatocellular carcinoma: a clinical study

Area of Science:

• Hepatology
• Oncology
• Clinical Biochemistry

Background:

• Hepatocellular carcinoma (HCC) is a major global health concern.
• Alpha-fetoprotein (AFP) is a widely used tumor marker for HCC.
• Understanding factors influencing AFP levels is crucial for patient management.

Purpose of the Study:

• To investigate the determinants of elevated Alpha-fetoprotein (AFP) levels in patients with hepatocellular carcinoma (HCC).
• To identify independent predictors of raised AFP in an HCC cohort.

Main Methods:

• Retrospective analysis of 51 consecutive HCC patients over 12 years.
• Measurement of serum Alpha-fetoprotein (AFP) levels.
• Statistical analysis including univariate methods and multivariate logistic regression.

Main Results:

• 31 out of 51 patients had AFP levels exceeding 20 ng/mL; 25 exceeded 200 ng/mL.
• Univariate analysis suggested associations with male gender, Asian ethnicity, chronic active hepatitis, and chronic hepatitis B infection.
• Multivariate analysis identified Hepatitis B surface antigen (HBsAg) carriage as the sole statistically significant independent determinant of raised AFP.
• Older age (≥65 years) was also associated with a higher chance of elevated AFP.

Conclusions:

• Hepatitis B surface antigen (HBsAg) carriage is the most significant independent predictor of elevated AFP in HCC.
• While other factors show associations, HBsAg status is paramount in determining raised AFP levels.
• AFP monitoring in HCC patients should consider HBsAg status for accurate interpretation.