ArticleClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2021
Serum Levels of α-Fetoprotein Increased More Than 10 Years Before Detection of Hepatocellular Carcinoma.
Article in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 2 of them syntheses that pooled it.
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Who cites it
19 citing papers in PubMed, 2 syntheses or guidelines pooled it, 37 citations in OpenAlex.
- EASL-EASD-EASO Clinical Practice Guidelines on the Management of Metabolic Dysfunction-Associated Steatotic Liver Disease (MASLD).Obesity facts · 2024Guideline
- Pooled it
- Metabolic dysfunction-associated steatotic liver disease assessment and management: Clinical practice guidance from the Canadian Association for the Study of the Liver.Canadian liver journal · 2026Article
- Trajectory Modelling of Prognostic Biomarkers Linked to Liver Cancer Risk: A Systematic Review.Liver cancer · 2026Article
- Advances in nanomaterial-enhanced immunosensors for ultra-sensitive tumor marker detection: Enabling early cancer diagnostics.Frontiers in chemistry · 2026Review
- Article
- Metabolomics biomarkers of hepatocellular carcinoma in a prospective cohort of patients with cirrhosis.JHEP reports : innovation in hepatology · 2024Article
- Circulating biomarkers in the diagnosis and management of hepatocellular carcinoma.Nature reviews. Gastroenterology & hepatology · 2022Review
- The Combination of AFP and "Up-To-Seven" Criteria May Be a Better Strategy for Liver Transplantation in Chinese Cirrhotic HCC Patients.Frontiers in oncology · 2022Article
- Liver cancer risk-predictive molecular biomarkers specific to clinico-epidemiological contexts.Advances in cancer research · 2022Article
- Current and Emerging Tools for Hepatocellular Carcinoma Surveillance.Hepatology communications · 2021Review
- The Emerging Influences of Alpha-Fetoprotein in the Tumorigenesis and Progression of Hepatocellular Carcinoma.Cancers · 2021Review
- GALAD Score Detects Early-Stage Hepatocellular Carcinoma in a European Cohort of Chronic Hepatitis B and C Patients.Pharmaceuticals (Basel, Switzerland) · 2021Article
- A blood-based prognostic liver secretome signature and long-term hepatocellular carcinoma risk in advanced liver fibrosis.Med (New York, N.Y.) · 2021Article
- Review
- The effect of random-effects misspecification on classification accuracy.The international journal of biostatistics · 2021Article
- Knockdown of MUC16 (CA125) Enhances the Migration and Invasion of Hepatocellular Carcinoma Cells.Frontiers in oncology · 2021Article
- Clinical and Molecular Prediction of Hepatocellular Carcinoma Risk.Journal of clinical medicine · 2020Review
- Long-term prognosis and management of hepatocellular carcinoma after curative treatment.Clinical and molecular hepatology · 2020Article
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Authors and funding
16 authors at 9 institutions in 2 countries.
Funding
Abstract
BACKGROUND &
aimsUltrasound (US)-based screening has been recommended for patients with an increased risk of hepatocellular carcinoma (HCC). US analysis, however, is limited in patients who are obese or have small tumors. The addition of serum level of α-fetoprotein (AFP) measurements to US analysis can increase detection of HCC. We analyzed data from patients with chronic liver disease, collected over 15 years in an HCC surveillance program, to develop a model to assess risk of HCC.
methodsWe collected data from 3450 patients with chronic liver disease undergoing US surveillance in Japan from March 1998 through April 2014, and followed them up for a median of 8.83 years. We performed longitudinal discriminant analysis of serial AFP measurements (median number of observations/patient, 56; approximately every 3 months) to develop a model to determine the risk of HCC. We validated the model using data from 2 cohorts of patients with chronic liver disease in Japan (404 and 2754 patients) and 1 cohort in Scotland (1596 patients).
resultsHCC was detected in 413 patients (median tumor diameter, 1.8 cm), during a median follow-up time of 6.60 years. In the development data set, the model identified patients who developed HCC with an area under the curve of 0.78; it correctly identified 74.3% of patients who did develop HCC, and 72.9% of patients who did not. Overall, 73.1% of patients were classified correctly. The model could be used to assign patients to a high-risk group (27.5 HCCs/1000 patient-years) vs a low-risk group (4.9 HCCs/1000 patient-years). A similar performance was observed when the model was used to assess patients with cirrhosis. Analysis of the validation cohorts produced similar results.
conclusionsWe developed and validated a model to identify patients with chronic liver disease who are at risk for HCC based on change in serum AFP level over time. The model could be used to assign patients to high-risk vs low-risk groups, and might be used to select patients for surveillance.
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