Reappraisal of the roles of alpha-fetoprotein in hepatocellular carcinoma surveillance using large-scale nationwide database and hospital-based information
Background/Purpose: Controversies over the use of alpha-fetoprotein (AFP) for detection of hepatocellular carcinoma (HCC) existed from guidelines. Using large-scale database and hospital-based information, we aimed to reappraise the role of AFP in HCC surveillance, including proportion of AFP elevat...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | Journal of the Formosan Medical Association |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0929664622001449 |
| _version_ | 1828145016401297408 |
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| author | Shu-Hsien Lin Chih-Yun Lin Nien-Tzu Hsu Yi-Hao Yen Kwong-Ming Kee Jing-Houng Wang Tsung-Hui Hu Chien-Hung Chen Chao-Hung Hung Chien-Hung Chen Jui-Ting Hu Yi-Hsiang Huang Tsang-En Wang Sheng-Nan Lu |
| author_facet | Shu-Hsien Lin Chih-Yun Lin Nien-Tzu Hsu Yi-Hao Yen Kwong-Ming Kee Jing-Houng Wang Tsung-Hui Hu Chien-Hung Chen Chao-Hung Hung Chien-Hung Chen Jui-Ting Hu Yi-Hsiang Huang Tsang-En Wang Sheng-Nan Lu |
| author_sort | Shu-Hsien Lin |
| collection | DOAJ |
| description | Background/Purpose: Controversies over the use of alpha-fetoprotein (AFP) for detection of hepatocellular carcinoma (HCC) existed from guidelines. Using large-scale database and hospital-based information, we aimed to reappraise the role of AFP in HCC surveillance, including proportion of AFP elevation by stage of HCC, additional benefit of AFP in combination of ultrasonography (US) in the detection of early HCC, and survival in early HCC with high AFP levels. Methods: This retrospective study enrolled 43,437 patients from database of the Taiwan Cancer Registry (TCR) and 4250 patients from Kaohsiung Chang Gung Memorial Hospital (KCGMH) between January 2011 and December 2017. Results: The HCC cases in KCGMH accounted for 9.8% of the total cases in the TCR. Among both nationwide database and hospital-based information, the proportion of early HCC patients with an AFP level of ≥20 ng/mL was approximately 40%. In KCGMH, the proportion of patients with an AFP level of ≥20 ng/mL and a virus-related (hepatitis B and C) etiology was around 41.7%; furthermore, among patients with early HCC, those with an AFP level of ≥20 ng/mL had 4.7 years of median survival and 48.3% of the 5-year overall survival rate. By hospital electronic medical records review of early HCC cohort in KCGMH, approximately 10.9% of patients with AFP levels ≥20 ng/mL had US-undetectable early HCC. Conclusion: This study suggested that AFP in combination with US would add an additional benefit as being a prompted role for detection of early HCC in patients with US-undetectable HCC. |
| first_indexed | 2024-04-11T20:26:54Z |
| format | Article |
| id | doaj.art-37a32f9134e84fe6a6b6cd2b023d9553 |
| institution | Directory Open Access Journal |
| issn | 0929-6646 |
| language | English |
| last_indexed | 2024-04-11T20:26:54Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Journal of the Formosan Medical Association |
| spelling | doaj.art-37a32f9134e84fe6a6b6cd2b023d95532022-12-22T04:04:38ZengElsevierJournal of the Formosan Medical Association0929-66462022-10-011211020852092Reappraisal of the roles of alpha-fetoprotein in hepatocellular carcinoma surveillance using large-scale nationwide database and hospital-based informationShu-Hsien Lin0Chih-Yun Lin1Nien-Tzu Hsu2Yi-Hao Yen3Kwong-Ming Kee4Jing-Houng Wang5Tsung-Hui Hu6Chien-Hung Chen7Chao-Hung Hung8Chien-Hung Chen9Jui-Ting Hu10Yi-Hsiang Huang11Tsang-En Wang12Sheng-Nan Lu13Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanBiostatistics Center of Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, TaiwanBiostatistics Center of Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine, National Taiwan University Hospital Yunlin Branch, Douliou, Taiwan; Liver Cancer Clinical Professional Advisory Board of Taiwan Cooperative Oncology Group, TaiwanLiver Center, Cathay General Hospital Medical Center, Taipei, Taiwan; Liver Cancer Clinical Professional Advisory Board of Taiwan Cooperative Oncology Group, TaiwanDivision of Gastroenterology and Hepatology, Taipei Veterans General Hospital, Taipei, Taiwan; Liver Cancer Clinical Professional Advisory Board of Taiwan Cooperative Oncology Group, TaiwanDivision of Gastroenterdfvology, Department of Internal Medicine, MacKay Memorial Hospital, Taipei, Taiwan; Liver Cancer Clinical Professional Advisory Board of Taiwan Cooperative Oncology Group, TaiwanDivision of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan; Liver Cancer Clinical Professional Advisory Board of Taiwan Cooperative Oncology Group, Taiwan; Corresponding author. Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123, Ta-Pei Road, Niao-Sung District, Kaohsiung 83305, Taiwan, ROC. Fax: +866 7 7322402.Background/Purpose: Controversies over the use of alpha-fetoprotein (AFP) for detection of hepatocellular carcinoma (HCC) existed from guidelines. Using large-scale database and hospital-based information, we aimed to reappraise the role of AFP in HCC surveillance, including proportion of AFP elevation by stage of HCC, additional benefit of AFP in combination of ultrasonography (US) in the detection of early HCC, and survival in early HCC with high AFP levels. Methods: This retrospective study enrolled 43,437 patients from database of the Taiwan Cancer Registry (TCR) and 4250 patients from Kaohsiung Chang Gung Memorial Hospital (KCGMH) between January 2011 and December 2017. Results: The HCC cases in KCGMH accounted for 9.8% of the total cases in the TCR. Among both nationwide database and hospital-based information, the proportion of early HCC patients with an AFP level of ≥20 ng/mL was approximately 40%. In KCGMH, the proportion of patients with an AFP level of ≥20 ng/mL and a virus-related (hepatitis B and C) etiology was around 41.7%; furthermore, among patients with early HCC, those with an AFP level of ≥20 ng/mL had 4.7 years of median survival and 48.3% of the 5-year overall survival rate. By hospital electronic medical records review of early HCC cohort in KCGMH, approximately 10.9% of patients with AFP levels ≥20 ng/mL had US-undetectable early HCC. Conclusion: This study suggested that AFP in combination with US would add an additional benefit as being a prompted role for detection of early HCC in patients with US-undetectable HCC.http://www.sciencedirect.com/science/article/pii/S0929664622001449α-fetoprotein (AFP)Ultrasonography (US)Hepatocellular carcinoma (HCC)SurveillanceEarly detection |
| spellingShingle | Shu-Hsien Lin Chih-Yun Lin Nien-Tzu Hsu Yi-Hao Yen Kwong-Ming Kee Jing-Houng Wang Tsung-Hui Hu Chien-Hung Chen Chao-Hung Hung Chien-Hung Chen Jui-Ting Hu Yi-Hsiang Huang Tsang-En Wang Sheng-Nan Lu Reappraisal of the roles of alpha-fetoprotein in hepatocellular carcinoma surveillance using large-scale nationwide database and hospital-based information Journal of the Formosan Medical Association α-fetoprotein (AFP) Ultrasonography (US) Hepatocellular carcinoma (HCC) Surveillance Early detection |
| title | Reappraisal of the roles of alpha-fetoprotein in hepatocellular carcinoma surveillance using large-scale nationwide database and hospital-based information |
| title_full | Reappraisal of the roles of alpha-fetoprotein in hepatocellular carcinoma surveillance using large-scale nationwide database and hospital-based information |
| title_fullStr | Reappraisal of the roles of alpha-fetoprotein in hepatocellular carcinoma surveillance using large-scale nationwide database and hospital-based information |
| title_full_unstemmed | Reappraisal of the roles of alpha-fetoprotein in hepatocellular carcinoma surveillance using large-scale nationwide database and hospital-based information |
| title_short | Reappraisal of the roles of alpha-fetoprotein in hepatocellular carcinoma surveillance using large-scale nationwide database and hospital-based information |
| title_sort | reappraisal of the roles of alpha fetoprotein in hepatocellular carcinoma surveillance using large scale nationwide database and hospital based information |
| topic | α-fetoprotein (AFP) Ultrasonography (US) Hepatocellular carcinoma (HCC) Surveillance Early detection |
| url | http://www.sciencedirect.com/science/article/pii/S0929664622001449 |
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