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Disease Markers 2022This study was conducted to investigate the effect of alpha-fetoprotein (AFP) ratio on the prognosis of AFP-positive hepatocellular carcinoma (HCC) patients after...
BACKGROUND
This study was conducted to investigate the effect of alpha-fetoprotein (AFP) ratio on the prognosis of AFP-positive hepatocellular carcinoma (HCC) patients after hepatectomy.
METHODS
We retrospectively included 879 HCC patients with AFP-positive who underwent hepatectomy from February 2012 to October 2017 and randomly divided into training cohort and validation cohort. AFP ratio was equal to the AFP level within one week before hepatectomy to AFP level within 20-40 days after surgery. The end point of follow-up was disease-free survival (DFS) and overall survival (OS).
RESULTS
AFP ratio was not associated with clinical characteristics in training cohort and validation cohort. According to the X-tile software, the optimum cut-off point was 17.8 for AFP ratio. Significant differences between AFP ratio high and AFP ratio low were observed in DFS and OS in both cohort ( < 0.05). Kaplan-Meier curves and receiver-operating curves were showed that AFP ratio was better than AFP level preoperation in predicting the prognosis of AFP-positive HCC patients after hepatectomy. The multivariate analysis demonstrated that AFP ratio was a significant independent risk factor for both OS and DFS in HCC patients with AFP-positive.
CONCLUSIONS
AFP ratio might be a prognosis predictor for HCC patients with AFP-positive after hepatectomy.
Topics: Carcinoma, Hepatocellular; Hepatectomy; Humans; Liver Neoplasms; Prognosis; Retrospective Studies; Survival Rate; alpha-Fetoproteins
PubMed: 35059044
DOI: 10.1155/2022/7640560 -
World Journal of Gastroenterology May 2017Hepatocellular carcinoma is becoming an increasing indication for liver transplantation, but selection and allocation of patients are challenging because of organ...
Hepatocellular carcinoma is becoming an increasing indication for liver transplantation, but selection and allocation of patients are challenging because of organ shortages. Conventional Milan criteria are the reference for the selection of patients worldwide, but many expanded criteria, like University of California San Francisco criteria and up-to-7 criteria, have demonstrated that survival and recurrence results are lower than those for restricted indications. Correct staging is crucial and should include surrogate markers of biological aggressiveness (α-fetoprotein, response to loco-regional treatments). Successful down-staging can select between patients with tumor burden initially beyond transplantation criteria those with a more favorable biology, provided a 3-mo stability in meeting the transplantation criteria. Allocation rules are constantly adjusted to minimize the imbalance between the priorities of candidates with and without hepatocellular carcinoma, and take into account local donor rate and waitlist dynamics. Recently, Mazzaferro et al proposed a benefit-oriented "adaptive approach", in which the selection and allocation of patients are based on their response to non-transplantation treatments: low priority for transplantation in case of complete response, high priority in case of partial response or recurrence, and no listing in case of progression beyond transplantation criteria.
Topics: Biomarkers; Carcinoma, Hepatocellular; Disease Progression; Europe; Humans; Liver Neoplasms; Liver Transplantation; Neoplasm Recurrence, Local; Neoplasm Staging; Patient Selection; Severity of Illness Index; Treatment Outcome; United States; alpha-Fetoproteins
PubMed: 28566879
DOI: 10.3748/wjg.v23.i18.3195 -
Therapeutic Delivery Jan 2018Alpha-fetoprotein is a shuttle protein that delivers nutrients through receptor-mediated endocytosis to embryotic cells. In adults, alpha-fetoprotein can shuttle drugs...
Alpha-fetoprotein is a shuttle protein that delivers nutrients through receptor-mediated endocytosis to embryotic cells. In adults, alpha-fetoprotein can shuttle drugs into alpha-fetoprotein receptor-positive myeloid-derived suppressor, regenerating and also cancer cells. Drugs with high-binding affinity to alpha-fetoprotein can activate or deplete targeted cells. Myeloid-derived suppressor cells activation leads to immune suppression that can be used for treating autoimmune diseases. On the other hand, toxins delivered by alpha-fetoprotein can damage myeloid-derived suppressor cells and consequently unleash innate and adaptive immunity to destroy cancer cells. Innate immunity natural killers reduce cancer stem cells and metastases. The new alpha-fetoprotein drug noncovalent complexes for immunotherapy change the local immune balance and has potential in oncology, autoimmune and infectious diseases treatment, inflammation, transplantation, vaccination, etc.
Topics: Autoimmune Diseases; Humans; Immunity, Innate; Immunotherapy; Ligands; Myeloid-Derived Suppressor Cells; Neoplasms; Toxins, Biological; alpha-Fetoproteins
PubMed: 29216804
DOI: 10.4155/tde-2017-0073 -
Critical Reviews in Analytical Chemistry 2024Early diagnosis of hepatocellular carcinoma (HCC), a leading cause of cancer mortality, is decisive for successful treatment of this type of cancer and increasing the... (Review)
Review
Early diagnosis of hepatocellular carcinoma (HCC), a leading cause of cancer mortality, is decisive for successful treatment of this type of cancer and increasing the patients' survival rate. Alpha-fetoprotein (AFP) is a glycoprotein that has been currently employed as a potential serological biomarker for determination of HCC and several other cancers. Achieving highly sensitive and specific detection of this biomarker is an effective strategy to inhibit developing issues caused by the cancer. Though, traditional procedures cannot meet the requirements due to the technical drawbacks. Recently, growing number of aptamer-based biosensors (aptasensors) attracted important attention as superior diagnostic tools because of their unique properties such as high stability, target versatility and remarkable affinity and selectivity. Nanomaterials, which broadly employed in the structure of these aptasensors, can considerably enhance the detection limit and sensitivity of analytes determination. Therefore, this review selectively investigated the recent progresses in several different optical and electrochemical aptasensors and nano-aptasensors designed for AFP assay.
Topics: alpha-Fetoproteins; Humans; Aptamers, Nucleotide; Biosensing Techniques; Electrochemical Techniques; Liver Neoplasms; Carcinoma, Hepatocellular; Biomarkers, Tumor
PubMed: 35969067
DOI: 10.1080/10408347.2022.2099221 -
Oncotarget Apr 2017Alpha-fetoprotein-producing gastric cancer (AFPGC) accounts for 1.5%-7.1% of all gastric cancer cases. Compared with other types of gastric cancer, AFPGC is more...
Alpha-fetoprotein-producing gastric cancer (AFPGC) accounts for 1.5%-7.1% of all gastric cancer cases. Compared with other types of gastric cancer, AFPGC is more aggressive and prone to liver and lymph node (LN) metastasis, with extremely poor prognosis. To improve understanding of AFPGC we reviewed a consecutive series of 82 AFPGC patients and investigated the prognostic factors. The incidence of AFPGC among our gastric cancer patients was 1.95%, and 29.27% of AFPGCs were diagnosed with metastasis at the time of presentation, mainly liver metastasis. The serum AFP level of patients with AFPGC was significantly associated with tumor differentiation. Histologically, these AFPGC patients were composed of 34.55% hapatiod type, 58.18% fetal gastrointestinal type, 9.09% yolk sac tumor-like type, and 14.55% mixed type. Patient gender, tumor differentiation, Lauren classification, and number of metastatic lymph nodes showed significant differences among these four subtypes. The overall survival time was 42.02 months and the 3-year cumulative survival rate was 53.13%. Age, American Joint Committee on Cancer (AJCC) TNM staging classification (TNM stage), serum AFP level, and surgery were prognostic factors for overall survival; however, TNM stage was the only independent risk factor for prognosis of AFPGC. In short, AFPGC is a rare, unique, and heterogeneous entity, and its proper identification and treatment remain a challenge. More attention should be paid to AFPGC to improve patient care and the dismal prognosis.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Prognosis; Risk Factors; Stomach Neoplasms; Survival Analysis; Young Adult; alpha-Fetoproteins
PubMed: 28423604
DOI: 10.18632/oncotarget.15909 -
APMIS : Acta Pathologica,... Mar 2022Alpha-fetoprotein-producing gastric cancer (AFPGC) is associated with high invasion and poor prognosis, but has not been well-documented due to its rarity. To develop...
Alpha-fetoprotein-producing gastric cancer (AFPGC) is associated with high invasion and poor prognosis, but has not been well-documented due to its rarity. To develop the understanding of AFPGC, and further facilitate its clinical decision-making and treatment, we performed clinicopathological and molecular characterization of AFPGC and its two major subtypes, namely, gastric adenocarcinoma with enteroblastic differentiation (GAED) and hepatoid adenocarcinoma (HAC). The clinicopathological and molecular characteristics of AFPGC patients (n = 54) were mainly investigated by immunohistochemistry and next-generation sequencing (NGS) approaches. AFPGC exhibited a higher incidence of lymphatic and vascular invasion than conventional gastric adenocarcinoma (CGA). Despite various morphological patterns, there was mostly no evident difference in clinicopathological characteristics between the GAED and HAC subtypes. Target-enriched NGS profiling of disease mutation landscapes discovered 17 differentially mutated genes between AFPGC and CGA. The AFPGC patients carrying ZNF217 mutations had poorer overall survival than the ZNF217 wildtype. Furthermore, ATR showed a significantly higher mutation rate in GAED than in HAC. Overall, our study of clinicopathological characteristics shed light on the differences between CGA and AFPGC, as well as the relationships between the GAED and HAC subtypes of AFPGC. Furthermore, mutation landscape profiling revealed potential diagnostic and prognostic markers for AFPGC and its two subtypes.
Topics: Adenocarcinoma; Biomarkers, Tumor; Female; Humans; Immunohistochemistry; Male; Middle Aged; Mutation; Stomach Neoplasms; alpha-Fetoproteins
PubMed: 34862662
DOI: 10.1111/apm.13196 -
Clinical Chemistry and Laboratory... May 2019Background Measurement of α-fetoprotein (AFP) concentrations in the serum of infants is useful for the management of testicular germ cell tumors, hepatoblastoma and... (Review)
Review
Background Measurement of α-fetoprotein (AFP) concentrations in the serum of infants is useful for the management of testicular germ cell tumors, hepatoblastoma and hepatocellular carcinoma. Here, we provide a critical review of the available information about pediatric reference intervals (RI), focusing on their utility in interpreting AFP as an aid for cancer diagnosis. Content Evidence sources in the available literature were critically appraised. Out of 3873 retrieved papers, 24 were finally selected and carefully inspected, and six of them overcame exclusion criteria (i.e. methodological limitations in the study design, statistical gaps, drawbacks in traceability of the AFP assay to higher order materials and/or biased reporting of AFP results). Preterm and term infants up to the 3rd month of life exhibited the highest average AFP concentrations, but the attempt of defining RI by data pooling and partitioning for age intervals was impeded by the wide variability of data. The inability of defining robust RI in the first months of life made difficult, if not impossible, using upper reference limits for ruling out malignancies with a single AFP result. Evaluating the behavior of AFP concentrations 5 days from the baseline result, if this exceeds risk thresholds partitioned for age, according to the formula Xt=X0*2-t/HL (where: t=days elapsed for AFP retest; HL=AFP half-life according to age; X0=AFP baseline concentration, and Xt=predicted AFP concentration at day 5), could give a better information. Summary Novel studies defining AFP RI in infants based on robust methodology are warranted to improve the interpretation of AFP results in pediatric oncology. In the meantime, algorithms based on both serum AFP absolute concentrations and HL may aid in cancer diagnosis.
Topics: Age Factors; Carcinoma, Hepatocellular; Hepatoblastoma; Humans; Immunoassay; Liver Neoplasms; Neoplasms, Germ Cell and Embryonal; Reference Values; Sex Factors; Testicular Neoplasms; alpha-Fetoproteins
PubMed: 30367785
DOI: 10.1515/cclm-2018-0803 -
Mikrochimica Acta Dec 2022α-Fetoprotein (AFP) is a kind of fetal protein that is related to tumor, the increasing concentration of which gives birth to a large variety of diseases, such as liver... (Review)
Review
α-Fetoprotein (AFP) is a kind of fetal protein that is related to tumor, the increasing concentration of which gives birth to a large variety of diseases, such as liver cancer. Therefore, the detection method with super sensitivity, high selectivity, and less time consumption under trace concentrations in early stage of diseases is becoming a necessity. In recent years, nanomaterials have been regarded as significant resources for the exploration of efficient biosensors with high sensitivity, selectivity, speed, as well as simple process, due to their excellent optical, electrical, and chemical properties. In this paper, we reviewed the research progress of AFP biosensors with enhanced sensitivity and selectivity by nanoparticles. Representative examples have also been displayed in this paper to expound the nanotechnologies utilized in the early detection of AFP. Furthermore, challenges of the clinical application of AFP biosensors based on nanotechnology have been elaborated, as well as the development opportunity in this field in the future. This review provides a comprehensive overview on the various nano-biosensor for AFP detection based on functional nanotechnology.
Topics: alpha-Fetoproteins; Nanotechnology; Biosensing Techniques; Nanostructures; Nanoparticles
PubMed: 36469175
DOI: 10.1007/s00604-022-05592-z -
BMC Research Notes Nov 2023This study aims to describe the diagnostic performance of alpha-fetoprotein (AFP), alpha-fetoprotein L3 isoform (AFP-L3), protein induced by vitamin K absence II...
OBJECTIVE
This study aims to describe the diagnostic performance of alpha-fetoprotein (AFP), alpha-fetoprotein L3 isoform (AFP-L3), protein induced by vitamin K absence II (PIVKA-II), and combined biomarkers for non-B non-C hepatocellular carcinoma (NBNC-HCC).
RESULTS
A total of 681 newly-diagnosed primary liver disease subjects (385 non-HCC, 296 HCC) who tested negativity for the hepatitis B surface antigen (HBsAg) and hepatitis C antibody (anti-HCV) enrolled in this study. At the cut-off point of 3.8 ng/mL, AFP helps to discriminate HCC from non-HCC with an area under the curve (AUC) value of 0.817 (95% confidence interval [CI]: 0.785-0.849). These values of AFP-L3 (cut-off 0.9%) and PIVKA-II (cut-off 57.7 mAU/mL) were 0.758 (95%CI: 0.725-0.791) and 0.866 (95%CI: 0.836-0.896), respectively. The Bayesian Model Averaging (BMA) statistic identified the optimal model, including patients' age, aspartate aminotransferase, AFP, and PIVKA-II combination, which helps to classify HCC with better performance (AUC = 0.896, 95%CI: 0.872-0.920, P < 0.001). The sensitivity and specificity of the optimal model reached 81.1% (95%CI: 76.1-85.4) and 83.2% (95%CI: 78.9-86.9), respectively. Further analyses indicated that AFP and PIVKA-II markers and combined models have good-to-excellent performance detecting curative resected HCC, separating HCC from chronic hepatitis, dysplastic, and hyperplasia nodules.
Topics: Humans; Carcinoma, Hepatocellular; alpha-Fetoproteins; Liver Neoplasms; Vitamin K; Vitamins; Bayes Theorem; ROC Curve; Biomarkers; Biomarkers, Tumor
PubMed: 37932802
DOI: 10.1186/s13104-023-06600-y -
Proteomics. Clinical Applications Jul 2021Fucosylation of alpha-fetoprotein (AFP) is closely correlated with the diagnosis of patients with hepatocellular carcinoma (HCC). In current, a micro-total analysis... (Comparative Study)
Comparative Study
PURPOSE
Fucosylation of alpha-fetoprotein (AFP) is closely correlated with the diagnosis of patients with hepatocellular carcinoma (HCC). In current, a micro-total analysis system (μTAS) using immunoassay has been developed for determining fucosylated AFP EXPERIMENTAL DESIGN: We compared two analytical methods, μTAS and liquid chromatography-parallel reaction monitoring mass spectrometry (LC-PRM MS), for the measurement of fucosylated AFP in serum to evaluate the usefulness of the results. For this purpose, serum samples were used (cirrhosis, n = 105; HCC, n = 105), and we have discussed the analytical performance of these two methods RESULTS: We observed a correlation (R = 0.84) between LC-PRM MS and μTAS using samples where fucosylated levels were measured by both methods. The fucosylated level of AFP by LC-PRM MS better differentiated between cirrhosis and HCC patients than those by μTAS (AUC = 0.910 vs. 0.861), particularly in subgroups with a level of total AFP < 20 ng/mL (0.973 vs. 0.874) and in early stage (I and II) patients (0.922 vs. 0.835) CONCLUSIONS AND CLINICAL RELEVANCE: From this comparative study we can suggest that the LC-PRM MS is applicable in the measurement of fucosylated AFP from human serum and is more useful for early diagnosis of HCC.
CLINICAL RELEVANCE
Fucosylation of AFP is used for the detection of HCC. A micro-total analysis system (μTAS) has been only developed for measuring fucosylation of AFP in clinical research. This study reports the fucosylation of AFP in human serum samples from cirrhosis and HCC patients using the μTAS and a LC-PRM MS to evaluate fucosylation of AFP from each method. As a result, LC-PRM MS is complementary to the conventional μTAS method. Furthermore, LC-PRM MS provides a higher diagnostic accuracy than the μTAS in patients with low AFP levels and an early stage.
Topics: Biomarkers, Tumor; Carcinoma, Hepatocellular; Chromatography, Liquid; Fucose; Glycosylation; Humans; Immunoassay; Liver Cirrhosis; Mass Spectrometry; Protein Processing, Post-Translational; ROC Curve; alpha-Fetoproteins
PubMed: 33764665
DOI: 10.1002/prca.202000096