Recent topics on α-fetoprotein.

Area of Science:

• Molecular Biology
• Hepatology
• Oncology

Background:

• Zinc-fingers and homeoboxes 2 (ZHX2) and ZBTB20 repress postnatal alpha-fetoprotein (AFP) expression by binding to its promoter.
• ZHX2 inhibits AFP, cyclin A, and cyclin E expression, while CUX1 negatively regulates ZBTB20, linking AFP reactivation to hepatocyte proliferation.

Purpose of the Study:

• To investigate the role of ZHX2 and ZBTB20 in AFP regulation.
• To explore the clinical significance of AFP levels in chronic hepatitis C and hepatocellular carcinoma (HCC).

Main Methods:

• Analysis of gene expression regulation by ZHX2 and ZBTB20.
• Review of clinical data correlating AFP levels with HCC development and treatment outcomes.

Main Results:

• ZHX2 and ZBTB20 interact with AFP gene promoter regions, repressing AFP expression.
• Elevated serum AFP in chronic hepatitis C, even without HCC, is an independent HCC risk factor.
• Sustained AFP elevation post-interferon therapy and AFP response to sorafenib are significant prognostic indicators for HCC patients.
• Lens culinaris agglutinin-reactive AFP (AFP-L3) aids early HCC detection in specific patient groups.

Conclusions:

• ZHX2 and ZBTB20 play a crucial role in suppressing AFP expression postnatally.
• AFP levels serve as a valuable biomarker for HCC risk assessment, prognosis, and treatment monitoring.
• AFP-L3 offers enhanced sensitivity for early HCC detection.