Korean J Intern Med.
2016 Jan;31(1):46-53. 10.3904/kjim.2016.31.1.46.
Feasibility of alpha-fetoprotein as a diagnostic tool for hepatocellular carcinoma in Korea
- Affiliations
-
- 1Department of Internal Medicine, Chung-Ang University College of Medicine, Seoul, Korea. mdjoon@cau.ac.kr
- 2Department of Anesthesiology and Pain, Chung-Ang University College of Medicine, Seoul, Korea.
- 3Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
- 4Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
- 5Department of Internal Medicine, Inje University Ilsan Paik Hospital, Goyang, Korea.
- KMID: 2373772
- DOI: http://doi.org/10.3904/kjim.2016.31.1.46
Abstract
- BACKGROUND/AIMS
The aim of this study was to evaluate the feasibility of alpha-fetoprotein (AFP) as a diagnostic tool for hepatocellular carcinoma (HCC) in Korean patients.
METHODS
We retrospectively reviewed the medical records of HCC and cirrhosis patients at three hospitals. For each HCC patient, a cirrhosis patient matched for age, sex, etiology, and Child-Pugh classification was selected by simple random sampling. The performance of AFP in the diagnosis of HCC was determined using receiver operating characteristic curve analysis.
RESULTS
A total of 732 patients with HCC or cirrhosis were selected for each case and the control groups. The mean age was 54 years, and 72.4% of patients were male. The mean serum AFP levels in the HCC group and cirrhosis group were 3,315.6 and 117.2 ng/mL, respectively (p < 0.001). The area under the receiver operating characteristic curve for all HCC patients was 0.757. The sensitivity, specificity, and positive predictive value of AFP was 50.55%, 87.70%, and 80.43%, respectively, at a cut-off of 20 ng/mL; 37.70%, 95.90%, and 90.20%, respectively, at a cut-off of 100 ng/mL, and 30.05%, 97.27%, and 91.67%, respectively, at a cut-off of 200 ng/mL. A cut-off of 100 ng/mL was more sensitive than one of 200 ng/mL with equivalent specificity and positive predictive value.
CONCLUSIONS
The cut-off AFP value for early-stage HCC was 17.4 ng/mL. Our study cautiously suggests that AFP has a role in the diagnosis of HCC, and that the appropriate value of AFP for the diagnosis of HCC may be 100 ng/mL rather than 200 ng/mL.
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