Effect of postoperative chemotherapy on the serum alpha-fetoprotein level in hepatoblastoma

Kubota, Masayuki; Yagi, Minoru; Kanada, Satoshi; Yamazaki, Satoru; Tanaka, Shinji; Asami, Keiko; Ogawa, Atsushi; Watanabe, Akihiro; Iwabuchi, Haruko; Kaneko, Michio; Saida, Yukihisa

doi:10.1016/j.jpedsurg.2004.08.038

Cited by 17 publications

(11 citation statements)

References 10 publications

(13 reference statements)

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“…However, the tumor was seen to involve the right hepatic vein as well as the middle and left at the pretransplantation exploration. elevated AFP levels at presentation, and a rise or fall in the AFP level may indicate efficacy of treatment [9,12,18]. In addition, AFP levels that do not decrease by 2 logs despite therapy have been found to have poor prognosis [19].…”

Section: Discussionmentioning

confidence: 99%

Survival after liver transplantation for hepatoblastoma: a 2-center experience

Browne

Sher

Grant

et al. 2008

Journal of Pediatric Surgery

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Section: Discussionmentioning

confidence: 99%

Survival after liver transplantation for hepatoblastoma: a 2-center experience

Browne

Sher

Grant

et al. 2008

Journal of Pediatric Surgery

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“…[11][12][13][14][15][16] Lastly, 90% to 95% of embryonic cancers (embryonic carcinomas, yolk sac tumors, hepatoblastoma) and 50% to 80% HCC show AFP reexpression during tumor development at levels from 10 ng/mL to 1 mg/mL. 10,[17][18][19] Thus, all individuals have been exposed to high levels of this antigen during fetal development and those with liver diseases and ultimately HCC are exposed to this secreted antigen, often at high concentrations.Although the exact function of AFP remains speculative, it seems to be involved in cell differentiation, growth regulation, and carcinogenesis. There are putative AFP cell surface receptors on cancer cell lines (including HCC), and also on normal hepatocytes, placental and immune cells.…”

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confidence: 99%

AFP-specific CD4+ Helper T-cell Responses in Healthy Donors and HCC Patients

Evdokimova¹,

Liu²,

Potter³

et al. 2007

Journal of Immunotherapy

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SummaryHepatocellular carcinoma (HCC) is one of the most common cancers worldwide, and is often diagnosed at an advanced stage. We have investigated α-fetoprotein (AFP) as a tumor-associated antigen for HCC. We identified major histocompatibility complex class I-restricted peptide epitopes derived from AFP and studied CD8 + T-cell responses in vivo and in vitro in ongoing immunotherapy studies. Helper T cells are of critical importance in shaping the immune response; therefore, we investigated the frequency and function of AFP-specific CD4 + T cells in the general population and among HCC patients. CD4 + T-cell responses were assessed by direct ex vivo multicytokine enzyme-linked immunospot assay and by measurement of cytokine levels using a multicytokine assay. Our analysis indicates that healthy donors have very low frequencies of AFPspecific CD4 + T-cell responses, which are of T H 1 type, detectable ex vivo. In contrast, these T cells were either reduced or eliminated in HCC patients at advanced stages of disease. To better activate these cells, we compared the stimulatory capacity of both AFP protein-fed and AdVhAFP-engineered dendritic cells (DC). Healthy donors have CD4 + T-cell responses, which were activated in response to AFP protein-fed DC whereas HCC patients do not demonstrate significant responses to AFP protein. AdVhAFP-transduced DC were capable of activating higher frequency T H 1 CD4 + responses to AFP in both healthy donors and AFP-positive HCC patients. Importantly, CD4 + T-cell cytokine expression profiles were skewed towards interleukin-2 and interferon-γ production when activated by adenovirally engineered DC, which has therapeutic implications for vaccination efforts. Financial Disclosure: One of the authors is a coinventor on a recently granted US Patent (L. H. B., US Patent No. 7,098,306, "Method and compositions for treating hepatocellular cancer," granted August 2006), which covers some of the MHC class I peptides used in a recently published clinical trial testing AFP class I peptides pulsed onto autologous DC. The intellectual property is owned by the University of California, has not been licensed, and there has been no financial interest for the inventors, to date. The HCC patient PBMC samples used in this work were from that clinical trial. The remaining authors have declared there are no financial conflicts of interest related to this work. [1][2][3] However, the majority of cases are detected at advanced stages, which, even if adequately treated locally, relapse systemically, and HCC recurs in 75% to 100% of patients at 5 years. 4 There are no effective systemic therapies for this disease. 5,6 This leads to a 9% 5-year survival rate after diagnosis in the United States, the second lowest survival rate for any type of cancer. 7 NIH Public Accessα-fetoprotein (AFP) is the most common serum protein during embryonic development, and is a physiologic counterpart of adult serum albumin. Suppression of AFP synthesis occurs shortly after birth. However, AFP mRNA can be detected in hum...

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“…The AFP level monitoring represents a valuable marker of the response to the presurgical chemotherapy, in the evaluation of the excision result and for the precocious diagnosis of the hepatoblastoma relapse. The complete excision of the tumor determines the decrease of the AFP serum level, which will be normalized after 4-6 weeks [9]. The AFP serum level increases very much before the imagistic demonstration of the tumor relapse.…”

Section: Discussionmentioning

confidence: 99%

Embryonal/Fetal Subtype Hepatoblastoma: A Case Report

Spyridakis

Kepertis

Lampropoulos

et al. 2014

JCDR

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We present a case of five months old female infant hospitalized for the evaluation of an abdominal mass. The infant was born mature and prenatally, perinatally and family history were insignificant. The physical examination at hospitalisation revealed an infant with very good general status without fever. At the abdomen examination revealed a palpable mass in the epigastric area and over the midline in the left abdomen under the rib border without pain and with relatively smooth surface.Laboratory investigations revealed thrombocytosis and high values of the serum alpha-fetoprotein (AFP) >35350ng/ml, betahuman chorionic gonadotropin (βHCG) < 0.605 mIU/ml, lactate dehydrogenase (LDH) 991 U/I, ferritin 163.44 ng/ml, c-reactive protein (CRP) 1.89 mg/dl, aspartate aminotransferase (AST) 74 U/I, alanine aminotransferase (ALT) 19 U/I, gamma-glutamyl transpeptidase (GGT) 252 U/I, hematocrit (Ht) 37%, hemoglobin (Hb) 11g/dl, platelets (PLT) 834000/mm The patient's age, clinical-imaging data, thrombocytosis and high value of AFP raised the suspicion of a hepatoblastoma.The patient was operated and a well-defined tumor 10/10 cm without vascular invasion was detected in the segments II-III 5]. A left lobectomy (segmentectomy 2 and 3) was performed. Surgery SectionThe pathological diagnosis was of embryonal/fetal subtype hepatoblastoma, totally removed. In multiple section received from the tumour, there has been a histological picture of hepatic neoplasm of areas consisting of trabecular solid or rosette like formation with cells with dark staining nuclei and frequent mitosis. There are cells with less atypia among which several foci of hepatopoeiesis. Mesenchymal elements are not recognised. Immunohistochemical analysis showed the neoplasmatic cells were positive to a FP, focally positive to CD99 and negative to S-100.The postsurgical evolution was favourable. The patient was transferred to the Department of Pediatrics where she tolerated welltreatment with Cisplatin 2mg/Kg for 3 courses every 2 weeks.Two months after the surgery the clinical biological evaluation was normal without hepatosplenomegaly, normal platelets values and AFP was 823ng/ml. The echographic re-evaluation indicate a hepatic parenchyma without foci lesions. DisCussionThe incidence of hepatoblastoma in USA and Europe seems to be 1.2 to 1.5 cases per million population and the rates in boys (1.57) are higher than in girls (1.09). In all pediatric malignancies it is still a rare tumor, comprising approximately 1% [1-3].The suspicion of child's hepatic tumor is based on history, clinical, biological and imaging data.The clinical presentation usually is an asymptomatic abdominal\ mass and sometimes accompanied with fever, fatigue, anorexia and weight loss. Severe symptoms such as obstructive jaundice and tumor rupture are relatively rare occurrences [1,4].Embryonal/Fetal Subtype Hepatoblastoma: A Case Report aBstRaCt Hepatoblastoma is the most common primary liver tumor of childhood and after neuroblastoma and nephroblastoma the third most common abdominal...

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Effect of postoperative chemotherapy on the serum alpha-fetoprotein level in hepatoblastoma

Cited by 17 publications

References 10 publications

Survival after liver transplantation for hepatoblastoma: a 2-center experience

Survival after liver transplantation for hepatoblastoma: a 2-center experience

AFP-specific CD4+ Helper T-cell Responses in Healthy Donors and HCC Patients

Embryonal/Fetal Subtype Hepatoblastoma: A Case Report

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