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20 July 2022 : Original article  

[In Press] Diagnostic Role of Tumor Markers for Hepatocellular Carcinoma in Liver Transplantation Candidates: An Analysis Using the Korean Organ Transplantation Registry Database

Woo-Hyoung Kang ORCID logo1ABCDE, Shin Hwang1ABCDEFG, Jong Man Kim ORCID logo2BCE, Kwang-Woong Lee3BDE, Dong Jin Joo4BDE, Young Kyoung You5BDE, Je Ho Ryu6BCE, Bong-Wan Kim7BDE, Donglak Choi8BDE, Dong-Sik Kim ORCID logo9BDE, Yang Won Nah10BDE

DOI: 10.12659/AOT.936937

Ann Transplant In Press; DOI: 10.12659/AOT.936937  

Available online: 2022-07-20, In Press, Corrected Proof

Publication in the "In-Press" formula aims at speeding up the public availability of the pending manuscript while waiting for the final publication. The assigned DOI number is active and citable. The availability of the article in the Medline, PubMed and PMC databases as well as Web of Science will be obtained after the final publication according to the journal schedule

Abstract

BACKGROUND
This study analyzed pretransplant alpha-fetoprotein (AFP) and proteins induced by vitamin K absence or antagonist-II (PIVKA-II) in liver transplantation (LT) candidates.
MATERIAL AND METHODS
A total of 3,273 LT recipients enrolled at the Korean Organ Transplantation Registry were divided according to hepatocellular carcinoma (HCC) status and background liver disease, and AFP and PIVKA-II were compared.
RESULTS
In all patients, the median AFP and PIVKA-II were 6.3 ng/mL and 29 mAU/mL in the viable-HCC group and 3.3 ng/mL and 35 mAU/mL, respectively, in the no-HCC group (P<0.001 for AFP and p=0.037 for PIVKA-II). In patients with hepatitis B virus infection, they were 6.0 ng/mL and 26 mAU/mL in the HCC group and 3.2 ng/mL and 21 mAU/mL in the no-HCC group, respectively (P<0.001 and P<0.001). In patients with hepatitis C virus infection, they were 10.7 ng/mL and 37 mAU/mL in the HCC group and 2.6 ng/mL and 21 mAU/mL in the no-HCC group, respectively (P<0.001 and P=0.117). In alcoholic liver disease patients, they were 5.2 ng/mL and 61 mAU/mL in the HCC group and 6.4 ng/mL and 75 mAU/mL in the no-HCC group, respectively (P<0.001 and P=0.419). In patients with other diseases, they were 7.1 ng/mL and 32 mAU/mL in the HCC group and 3.3 ng/mL and 28 mAU/mL in the no-HCC group, respectively (P<0.001 and P=0.822).
CONCLUSIONS
The results of the present study indicate that pretransplant serum AFP and PIVKA-II were highly variably expressed in LT candidates with end-stage liver diseases; therefore, their values should be cautiously interpreted because their role in HCC diagnosis is limited.

Keywords: Liver Neoplasms; Hepatocellular Carcinoma; Tumor Marker; Liver Transplantation; Carcinogenesis; Viral Hepatitis

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Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358