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Predictive value of tumor markers for hepatocarcinogenesis in patients with hepatitis C virus

  • Original Article—Liver, Pancreas, and Biliary Tract
  • Published:
Journal of Gastroenterology Aims and scope Submit manuscript

Abstract

Background

Increases in tumor markers are sometimes seen in patients with chronic liver disease without hepatocellular carcinoma (HCC). The aim of this study was to determine the relationship between the levels of three tumor markers [alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3%), and des-γ-carboxy prothrombin (DCP)] and hepatic carcinogenesis to identify hepatitis C virus (HCV) carriers at high risk for cancer development.

Methods

A total of 623 consecutive HCV carriers with follow-up periods of >3 years were included. The average integration values were calculated from biochemical tests, and tumor markers, including AFP, AFP-L3%, and DCP, and factors associated with the cumulative incidence of HCC were analyzed.

Results

HCC developed in 120 (19.3%) of the 623 patients. Age >65 years [adjusted relative risk, 2.303 (95% confidence interval, 1.551–3.418), P < 0.001], low platelet count [3.086 (1.997–4.768), P < 0.001], high aspartate aminotransferase value [3.001 (1.373–6.562), P < 0.001], high AFP level [≥10, <20 ng/mL: 2.814 (1.686–4.697), P < 0.001; ≥20 ng/mL: 3.405 (2.087–5.557), P < 0.001] compared to <10 ng/mL, and high AFP-L3% level [≥5, <10%: 2.494 (1.291–4.816), P = 0.007; ≥10%: 3.555 (1.609–7.858), P < 0.001] compared to <5% were significantly associated with an increased incidence of HCC on multivariate analysis.

Conclusions

Increased AFP or AFP-L3% levels were significantly associated with an increased incidence of HCC. Among HCV carriers, patients with ≥10 ng/mL AFP or patients with ≥5% AFP-L3% are at very high risk for the development of HCC even if AFP is less than 20 ng/mL or AFP-L3% is less than 10%, which are the most commonly reported cutoff values.

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Acknowledgments

This work was supported by a grant from the Ministry of Health, Labour and Welfare of Japan.

Conflict of interest

There is no conflict of interest to disclose.

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Authors and Affiliations

  1. Department of Gastroenterology, Ogaki Municipal Hospital, 4-86, Minaminokawa-cho, Ogaki, Gifu, 503-8052, Japan

    Takashi Kumada, Hidenori Toyoda, Seiki Kiriyama, Makoto Tanikawa, Yasuhiro Hisanaga, Akira Kanamori & Toshifumi Tada

  2. Department of Epidemiology, Infectious Disease Control and Prevention, Graduate School of Biomedical Sciences, Hiroshima University, Hiroshima, Japan

    Junko Tanaka & Hiroshi Yoshizawa

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  1. Takashi Kumada
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  2. Hidenori Toyoda
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Correspondence to Takashi Kumada.

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Kumada, T., Toyoda, H., Kiriyama, S. et al. Predictive value of tumor markers for hepatocarcinogenesis in patients with hepatitis C virus. J Gastroenterol 46, 536–544 (2011). https://doi.org/10.1007/s00535-010-0349-7

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  • DOI: https://doi.org/10.1007/s00535-010-0349-7

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