肝细胞癌监测：血清甲胎蛋白在现实世界中的益处。

StephenW

Euroasian J Hepatogastroenterol. 2018 Jan-Jun;8(1):83-87. doi: 10.5005/jp-journals-10018-1268. Epub 2018 May 1.
Hepatocellular Carcinoma Surveillance: Benefit of Serum Alfa-fetoprotein in Real-world Practice.
Lersritwimanmaen P1, Nimanong S1.
Author information

1
    Division of Gastroenterology, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.

Abstract
Introduction:

Better treatment outcome of early-stage hepatocellular carcinoma (HCC) warrants employment of screening programs, in which ultrasonography (US) and serum alfa-fetoprotein (AFP) have been recommended. Considering cost-effectiveness, serum AFP has recently been withdrawn from several guidelines for HCC surveillance. However, there were limited studies on benefits of AFP for HCC surveillance in Thailand.
Materials and methods:

This is a retrospective study of a proportion of HCC cases in which a diagnostic study was triggered by high serum AFP levels, but US failed to detect the lesion. Patients who received diagnostic imaging for HCC at Siriraj Hospital between January 1, 2012 and December 31, 2014 were included. All the patients must fulfill criteria for HCC surveillance according to American Association for the Study of Liver Diseases (AASLD) practice guidelines on the management of HCC 2010 or European Association for the Study of the Liver-European Organisation for Research and Treatment of Cancer (EASL-EORTC) Clinical Practice Guidelines: Management of HCC 2012. Previous diagnosis of any liver malignancy was excluded. Demographic data, underlying liver diseases, screening of AFP and US results, and definite diagnosis of HCC were recorded.
Results:

Of the 452 cases who fulfilled inclusion and exclusion criteria, chronic hepatitis B, C, and alcoholic cirrhosis were accountable for 53.8, 25.9, and 7.3% respectively. Totally, 150 cases were diagnosed with HCC. Additional HCC detection rate by high serum AFP but failed US of 15.3% was demonstrated. Subgroup analysis revealed significant benefit of AFP in cirrhotic patients with chronic hepatitis B and C (p-value 0.004 and 0.002). No significant benefit was observed in cirrhosis of other causes and in noncirrhotic chronic hepatitis B.
Conclusion:

We reported a 15.3% additional benefit of serum AFP for HCC surveillance in conjunction with US of liver. Chronic hepatitis B and C with cirrhosis significantly derived the benefit from serum AFP screening.How to cite this article: Lersritwimanmaen P, Nimanong S. Hepatocellular Carcinoma Surveillance: Benefit of Serum Alfa-fetoprotein in Real-world Practice. Euroasian J Hepato-Gastroenterol 2018;8(1):83-87.
KEYWORDS:

Alfa-fetoprotein; Hepatocellular carcinoma; Surveillance.

PMID:
    29963472
PMCID:
    PMC6024042
DOI:
    10.5005/jp-journals-10018-1268

StephenW

Euroasian J Hepatogastroenterol。 2018年1月至6月; 8（1）：83-87。 doi：10.5005 / jp-journals-10018-1268。 Epub 2018年5月1日。
肝细胞癌监测：血清甲胎蛋白在现实世界中的益处。
Lersritwimanmaen P1，Nimanong S1。
作者信息

1
    泰国曼谷玛希隆大学Siriraj医院医学系消化内科。

抽象
介绍：

早期肝细胞癌（HCC）的更好治疗结果需要采用筛查方案，其中推荐使用超声检查（US）和血清甲胎蛋白（AFP）。考虑到成本效益，血清AFP最近已从几项HCC监测指南中撤回。然而，关于AFP对泰国HCC监测的益处的研究有限。
材料和方法：

这是一项HCC病例的回顾性研究，其中一项诊断性研究由高血清AFP水平引发，但美国未能检测到病变。在2012年1月1日至2014年12月31日期间在Siriraj医院接受HCC诊断成像的患者被纳入。根据美国肝病研究协会（AASLD）关于HCC 2010管理实践指南或欧洲肝癌研究和治疗组织协会（EASL）的所有患者必须满足HCC监测标准-EORTC）临床实践指南：HCC 2012的管理。排除任何肝脏恶性肿瘤的既往诊断。记录人口统计学数据，潜在的肝脏疾病，AFP和US结果筛查，以及明确的HCC诊断。
结果：

在符合纳入和排除标准的452例患者中，慢性乙型肝炎，丙型肝炎和酒精性肝硬化分别为53.8％，25.9％和7.3％。共有150例被诊断为HCC。显示了高血清AFP的额外HCC检出率，但美国失败率为15.3％。亚组分析显示AFP在患有慢性乙型和丙型肝炎的肝硬化患者中具有显着益处（p值0.004和0.002）。在其他原因的肝硬化和非肝硬化慢性乙型肝炎中没有观察到显着的益处。
结论：

我们报道了与美国肝脏联合使用血清AFP对HCC监测的额外益处为15.3％。慢性乙型肝炎和C型肝硬化显着地从血清AFP筛查中获益。如何引用本文：Lersritwimanmaen P，Nimanong S.肝细胞癌监测：血清甲胎蛋白在现实世界中的益处。 Euroasian J Hepato-Gastroenterol 2018; 8（1）：83-87。
关键词：

甲胎蛋白;肝细胞癌;监控。

结论：
    29963472
PMCID：
    PMC6024042
DOI：
    10.5005 / JP-期刊-10018-1268