Interrelations between elevated alpha-fetoprotein levels and tumor morphology of patients with hepatocellular carcinoma

Vol. 60 No. 1, 2019


Elena Toader, Andrei Bancu, Dana Elena Mitrica, Gabriel Constantinescu, Gabriela Stefanescu, Gheorghe G. Balan

Background: Hepatocellular carcinoma (HCC) is one of the leading causes of cancer related deaths worldwide, while at the same time having a constant growth in incidence. A commonly used biomarker in managing liver cancer cases, alpha-fetoprotein (AFP) is losing clinical ground in favor of imaging studies and emerging biomarkers. The study aims to reassess potential prognosis indicators and risk factors for an elevated level of this glycoprotein by analyzing its relationship with macroscopic morphology tumor-related features. Patients, Materials and Methods: One hundred and thirty-one newly diagnosed HCC patients had their clinical, tumor and liver disease features investigated in contrast to elevated AFP levels with 200 IU/mL being used as preferred cut-off. Results: Tumor size >=5 cm [odds ratio (OR) 3.36, 95% confidence interval (CI): 1.29-8.74, p=0.013] is an independent tumor-related predictor of markedly elevated AFP values. Noteworthy connections with the type of tumor, multinodular appearance and portal vein thrombosis were also found through univariate analysis. Conclusions: AFP could still be a reliable tool in diagnosis and prognosis of HCC patients especially in developing countries due to its relevant association with aspects of advanced tumor and liver disease, gender and a poor functional status.

Corresponding author: Andrei Bancu, MD; e-mail:

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