'hepatoma-specific' alphafetoprotein may permit preclinical diagnosis of malignant change in patients with chronic liver disease

ABSTRACT The only hope for effective treatment of hepatocellular carcinoma (HCC or 'hepatoma') lies in early diagnosis. Measurement of the serum alphafetoprotein (AFP) level is

potentially a useful screening test. When grossly raised, it is almost diagnostic of HCC. However, modestly elevated levels may also arise in patients with benign chronic liver disease, and

this markedly decreases the test's specificity and hence its clinical value. In 582 consecutive attendees at an outpatient clinic for people with chronic liver disease, a single blood

sample was taken for analysis of 'total' AFP and the 'hepatoma-specific' AFP isoform. Using ultrasonography as the primary screening method, patients with AFP levels >

or = 50 ng ml-1 were followed up throughout the study or until HCC was diagnosed on the basis of conventionally defined criteria. On entry into the study, 53 patients had an AFP

concentration > = or 50 ng ml-1 and the 'hepatoma-specific' AFP isoform was detected in 26 of these. During an 18-month follow-up period, a diagnosis of HCC was established by

conventional methods in 19 (17 'definite' and two 'probable') of these 26 patients. In only two cases was there ultrasound evidence of tumour development at the time AFP

was first found to be elevated; in the remainder a diagnosis of HCC, based on ultrasound screening, was established at a median time of 3.6 months (range 1-18 months) after entry into the

study. Among those 27 without the 'hepatoma-specific' isoform, one developed a 'definite' HCC and two developed 'probable' tumours. With the application of

'hepatoma-specific' AFP, the positive predictive value of the test was 73.1%, compared with only 41.5% using the conventional 'total' AFP test. Application of this test

for the 'hepatoma-specific' AFP markedly increases the positive predictive value of AFP and, in some cases, permits the presence of tumour to be inferred before it could be

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subscriptions * Read our FAQs * Contact customer support SIMILAR CONTENT BEING VIEWED BY OTHERS ACUTE-PHASE SERUM AMYLOID A FOR EARLY DETECTION OF HEPATOCELLULAR CARCINOMA IN CIRRHOTIC

PATIENTS WITH LOW AFP LEVEL Article Open access 06 April 2022 COMBINING AFP, PIVKA-II, AND GP73 HAS DIAGNOSTIC UTILITY FOR HEPATITIS B-ASSOCIATED HEPATOCELLULAR CARCINOMA AND IS CONSISTENT

WITH LIVER PATHOLOGY RESULTS Article Open access 28 April 2025 EPCAM-POSITIVE CIRCULATING TUMOR CELLS AND SERUM AFP LEVELS PREDICT OUTCOME AFTER CURATIVE RESECTION OF HEPATOCELLULAR

CARCINOMA Article Open access 27 November 2023 AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Hepatoma Study Group, Sir YK Pao Cancer Centre, Shatin, NT, Hong Kong PJ Johnson Authors * PJ

Johnson View author publications You can also search for this author inPubMed Google Scholar * N Leung View author publications You can also search for this author inPubMed Google Scholar *

P Cheng View author publications You can also search for this author inPubMed Google Scholar * C Welby View author publications You can also search for this author inPubMed Google Scholar *

WT Leung View author publications You can also search for this author inPubMed Google Scholar * WY Lau View author publications You can also search for this author inPubMed Google Scholar *

S Yu View author publications You can also search for this author inPubMed Google Scholar * S Ho View author publications You can also search for this author inPubMed Google Scholar RIGHTS

AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Johnson, P., Leung, N., Cheng, P. _et al._ 'Hepatoma-specific' alphafetoprotein may permit preclinical

diagnosis of malignant change in patients with chronic liver disease. _Br J Cancer_ 75, 236–240 (1997). https://doi.org/10.1038/bjc.1997.39 Download citation * Issue Date: 01 January 1997 *

DOI: https://doi.org/10.1038/bjc.1997.39 SHARE THIS ARTICLE Anyone you share the following link with will be able to read this content: Get shareable link Sorry, a shareable link is not

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