血清甲胎蛋白在健康人群中诊断肝细胞癌的临床意义]

StephenW

Korean J Gastroenterol. 2017 Apr 25;69(4):232-238. doi: 10.4166/kjg.2017.69.4.232.
[The Clinical Significance of Serum Alpha-fetoprotein in Diagnosing Hepatocellular Carcinoma in a Health Screening Population].
[Article in Korean]
Ko YS1, Bae JH1, Sinn DH1, Gwak GY1, Kang W1, Paik YH1, Choi MS1, Lee JH1, Koh KC1, Paik SW1.
Author information

1    Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.

Abstract
Background/Aims:

Serum alpha-fetoprotein (AFP) measurement is commonly included in a health check-up program in Korea. However, its benefits remain uncertain. We analyzed whether AFP measurement should be included in a general health check-up program to screen for hepatocellular carcinoma (HCC).
Methods:

A total of 36,552 adults aged 18 years or older-who participated in a routine health examination including AFP determination between January 2009 and December 2009 at the Health Promotion Center, Samsung Medical Center, South Korea-were analyzed. High risk of HCC was defined as positivity for hepatitis B surface antigen, anti-hepatitis C virus antibody or having liver cirrhosis.
Results:

AFP level >10 ng/mL was observed in 27 participants (0.1%) and primary liver cancer was diagnosed in 9 patients (6 HCC and 3 cholangiocarcinoma). Among 1,619 participants with high risk factors of HCC, AFP level >10 ng/mL was observed in 16 participants, of which, 4 diagnoses were made. Sensitivity, specificity, positive predictive value, and negative predictive value of AFP for HCC was 0.66, 0.99, 0.25 and 0.99, respectively, for high risk participants. Among 34,933 participants without risk factors for HCC, 11 patients (<0.1%) showed elevated AFP levels above 10 ng/mL, and no case was diagnosed with primary liver cancer during a median follow-up period of 36 months (range: 0-48 months).
Conclusions:

AFP elevation was rare in participants without risk factors for HCC, and was unable to screen for HCC in this population. We discourage routine AFP measurements for asymptomatic adults without risk factors of HCC.
KEYWORDS:

Alpha-fetoprotein; Diagnosis; Hepatocellular carcinoma

PMID:
    28449425
DOI:
    10.4166/kjg.2017.69.4.232

StephenW

韩国J胃肠病。 2017年4月25日; 69（4）：232-238。 doi：10.4166 / kjg.2017.69.4.232。
[血清甲胎蛋白在健康人群中诊断肝细胞癌的临床意义]。
[韩文]
Ko YS1，Bae JH1，Sinn DH1，Gwak GY1，Kang W1，​​Paik YH1，Choi MS1，Lee JH1，Koh KC1，Paik SW1。
作者信息

1
    韩国首尔Sungkyunkwan大学医学院三星医学中心内科系。

抽象
背景/宗旨：

韩国的健康检查计划通常包含血清甲胎蛋白（AFP）测定。然而，它的好处仍然不确定。我们分析了AFP测量是否应包括在一般健康检查程序中以筛选肝细胞癌（HCC）。
方法：

分析了2009年1月至2009年12月在南韩三星医疗中心健康促进中心参加了日常健康检查的36,552名18岁以上的成年人。 HCC的高风险定义为乙型肝炎表面抗原，抗丙型肝炎病毒抗体或肝硬化的阳性。
结果：

27例患者（0.1％）观察到AFP水平> 10 ng / mL，9例（6例HCC和3例胆管癌）诊断为原发性肝癌。在1619名HCC高危因素参与者中，16名参与者中AFP水平> 10 ng / mL，其中4例诊断。 AFP对HCC的敏感性，特异性，阳性预测值和阴性预测值分别为高风险参与者的0.66,0.99,0.25和0.99。在34,933例无HCC危险因素的参与者中，11例（<0.1％）的AFP水平升高超过10 ng / mL，在36个月的中位随访期间未发现原发性肝癌病例（范围：0〜 48个月）。
结论：

在没有HCC危险因素的参与者中，AFP升高很少，无法筛选该人群中的HCC。我们不鼓励常规的AFP测量无症状成人没有HCC的危险因素。
关键词：

甲胎蛋白诊断;肝细胞癌

PMID：
    28449425
DOI：
    10.4166 / kjg.2017.69.4.232