25 October 2016 : Original article
Diagnostic Role of Blood Tumor Markers in Predicting Hepatocellular Carcinoma in Liver Cirrhosis Patients Undergoing Liver TransplantationYounghwan KimADEF, Yo-Han ParkACDE, Shin HwangABCDEFG, Ki-Hun KimBCD, Chul-Soo AhnBCD, Deok-Bog MoonBCD, Tae-Yong HaBCD, Gi-Won SongBCD, Dong-Hwan JungBCD, Gil-Chun ParkBCD, Sung-Gyu LeeABCD
Ann Transplant 2016; 21:660-667
BACKGROUND: The aim of this study was to investigate the diagnostic role of alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) in predicting hepatocellular carcinoma (HCC) in patients with advanced liver cirrhosis (LC) awaiting liver transplantation (LT).
MATERIAL AND METHODS: During a study period of 10 years, 2074 adult LT recipients were identified. They were divided into 2 groups: HCC (n=970; 46.8%) and non-HCC (n=1104; 53.2%). They were stratified into 5 categories according to model for end-stage liver disease (MELD) scores: <10 (n=464), ≥10 and <15 (n=632), ≥15 and <20 (n=355), ≥20 and <30 (n=340), and ≥30 (n=283).
RESULTS: Median pretransplant AFP vs. DCP levels were 11.3 ng/mL vs. 26 mAU/mL and 4.2 ng/mL vs. 22 mAU/mL in the HCC and non-HCC groups, respectively. Receiver-operator characteristic (ROC) curve analyses showed that area under the curve (AUC) of AFP was 0.693, having a crossing-point cutoff at 6.8 ng/mL with sensitivity of 64.5% and specificity of 64.5%. AUC of AFP was inversely correlated with MELD score. AUC of DCP was 0.546, having a crossing-point cutoff at 25 mAU/mL with sensitivity of 53.1% and specificity of 51.8%. AUC of DCP was <0.6 except in MELD score ≥30.
CONCLUSIONS: Diagnostic predictability of AFP was reliably associated with MELD score but that of DCP was not. The sensitivity of AFP and DCP is not high enough, especially in patients with MELD score ≥20. Thus, thorough HCC screening with imaging studies should be conducted during the waiting period for LT and pretransplant assessment.
Keywords: alpha-Fetoproteins, Hepatitis B virus, Liver Transplantation
17 May 2023 : Original articleResults of Liver Retransplantation After Rescue Hepatectomy: A Single-Center Study
Ann Transplant In Press; DOI: 10.12659/AOT.939557
10 May 2023 : Original articleIncidence of Thromboembolic Complications Following Kidney Transplantation with Short and Extended Aspirin ...
Ann Transplant In Press; DOI: 10.12659/AOT.939143
Most Viewed Current Articles
24 Aug 2021 : Review articleNormothermic Machine Perfusion (NMP) of the Liver – Current Status and Future Perspectives
Ann Transplant 2021; 26:e931664
26 Jan 2022 : Review articleRecurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models
Ann Transplant 2022; 27:e934924
29 Dec 2021 : Original articleEfficacy and Safety of Tacrolimus-Based Maintenance Regimens in De Novo Kidney Transplant Recipients: A Sys...
Ann Transplant 2021; 26:e933588
15 Mar 2022 : Case reportCombined Liver, Pancreas-Duodenum, and Kidney Transplantation for Patients with Hepatitis B Cirrhosis, Urem...
Ann Transplant 2022; 27:e935860