Half-Life of Serum Alpha-Fetoprotein

Shim, Ju Hyun; Han, Seungbong; Lee, Young‐Joo; Lee, Sung‐Gyu; Kim, Kang Mo; Lim, Young‐Suk; Chung, Young‐Hwa; Lee, Yung Sang; Lee, Han Chu

doi:10.1097/sla.0b013e318273be70

Cited by 21 publications

(5 citation statements)

References 27 publications

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“…Detection of serum AFP levels is a relatively well-established method that is used routinely for identifying HCC patients with a high risk of recurrence and metastasis after curative resection. [ 25 ] Microscopic vascular invasion occurs in approximately 44% of patients with HCC at the time of death. [ 26 ] Furthermore, the presence of microscopic vascular invasion has an adverse effect on prognosis.…”

Section: Discussionmentioning

confidence: 99%

Human U Three Protein 14a Expression is Increased in Hepatocellular Carcinoma and Associated with Poor Prognosis

Zhang

Liu

et al. 2017

Chinese Medical Journal

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Background:Human U three protein 14a (hUTP14a) promotes p53 degradation. Moreover, hUTP14a expression is upregulated in several types of tumors. However, the expression pattern of hUTP14a in hepatocellular carcinoma (HCC) remains unknown. The aim of this study was to investigate hUTP14a expression and its prognostic value in HCC.Methods:The hUTP14a expression was evaluated using immunohistochemistry (IHC) in HCC tissue specimens. The correlations between hUTP14a expression and clinicopathological variables were analyzed. The Kaplan-Meier method was used to analyze the association between hUTP14a expression and survival. Independent prognostic factors associated with overall survival (OS) and disease-free survival (DFS) were analyzed using the Cox proportional-hazards regression model.Results:The IHC data revealed that the hUTP14a positivity rate in HCC tissue specimens was significantly higher than that in nontumorous tissue specimens (89.9% vs. 72.7%, P < 0.05). The hUTP14a expression was detected in both the nucleolus and the cytoplasm. The positivity rate of nucleolar hUTP14a expression in HCC tissue specimens was higher than that in the nontumorous tissue specimens (29.3% vs. 10.1%, P < 0.05). No significant difference was found between HCC and nontumorous tissue specimens of cytoplasmic hUTP14a expression (60.6% vs. 62.6%, P > 0.05). In addition, no significant correlation was found between nucleolar hUTP14a expression and other clinicopathological variables. The 5-year OS and DFS rates in patients with positive nucleolar hUTP14a expression were significantly lower than those in patients with negative hUTP14a expression (P = 0.004 for OS, P = 0.003 for DFS). Multivariate analysis showed that nucleolar hUTP14a expression was an independent prognostic factor for OS (P = 0.004) and DFS (P < 0.001).Conclusions:The positivity rate of hUTP14a expression was significantly higher in HCC specimens. Positive expression of nucleolar hUTP14a might act as a novel prognostic predictor for patients with HCC.

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Section: Discussionmentioning

confidence: 99%

Human U Three Protein 14a Expression is Increased in Hepatocellular Carcinoma and Associated with Poor Prognosis

Zhang

Liu

et al. 2017

Chinese Medical Journal

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“…AFP response has not only been reported as a meaningful predictive factor for recurrence and survival in early stage HCC patients who receive curative treatments [ 13 , 15 , 16 ] but also has shown the prognostic value for radiologic response and survival rates in advanced HCC after palliative treatments [ 11 , 12 , 14 , 19 – 21 ]. Regarding patients with PVTT, few studies to date have analyzed the prognostic value of AFP response after treatment.…”

Section: Discussionmentioning

confidence: 99%

“…Based on the criteria used in previous sorafenib studies, we defined an AFP response as a reduction of >20% from the initial level. To improve the specificity and positive predictive value, other studies have alternatively defined the AFP response as a reduction of >50% compared to the initial level [ 14 , 15 , 20 ]. However, the proportion of AFP responders in those studies were similar to that of the present study, which may be due to similar evaluation times of AFP response used among studies.…”

Section: Discussionmentioning

confidence: 99%

Propensity Score Matching Analysis of Changes in Alpha-Fetoprotein Levels after Combined Radiotherapy and Transarterial Chemoembolization for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus

et al. 2015

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Background and AimTo investigate the value of changes in alpha-fetoprotein (AFP) levels for the prediction of radiologic response and survival outcomes in hepatocellular carcinoma (HCC) patients with portal vein tumor thrombus (PVTT) who received combined treatment of 3-dimensional conformal radiotherapy (3D-CRT) and transarterial chemoembolization (TACE).MethodsA database of 154 HCC patients with PVTT and elevated AFP levels (>20 ng/mL) treated with 3D-CRT and TACE as an initial treatment between August 2002 and August 2008 was retrospectively reviewed. AFP levels were determined 1 month after radiotherapy, and AFP response was defined as an AFP level reduction of >20% from the initial level. Radiologic response, overall survival (OS), and progression-free survival (PFS) rates were compared between AFP responders and non-responders. Propensity-score based matching analysis was performed to minimize the effect of potential confounding bias.ResultsThe median follow-up period was 11.1 months (range, 3.1–82.7 months). In the propensity-score matching cohort (92 pairs), a best radiologic response of CR or PR occurred in more AFP responders than AFP non-responders (41.3% vs. 10.9%, p < 0.001). OS and PFS were also longer in AFP responders than in non-responders (median OS 13.2 months vs. 5.6 months, p < 0.001; median PFS 8.7 months vs. 3.5 months, p < 0.001).ConclusionsAFP response is a significant predictive factor for radiologic response. Furthermore, AFP response is significant for OS and PFS outcomes. AFP evaluation after combined radiotherapy and TACE appears to be a useful predictor of clinical outcomes in HCC patients with PVTT.

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“…In Taiwan, a colonoscopy will be used as the diagnostic tool for following up at-risk individuals because it is affordable and available in nearly every hospital. At the same time, since many cases of mild risk may be at a pre-cancer status which is a dynamic stage between developing into a local tumor and being eliminated by the immune system, and the half-life of most tumor markers is less than several days [ 29 ], we would recommend that these individuals receive repeat tumor marker screenings in one month to verify the level of risk. Future repeat testing at 6–12-month intervals to monitor changes in overall score and individual biomarker levels would seem prudent.…”

Section: Discussionmentioning

confidence: 99%

Improving Multi-Tumor Biomarker Health Check-Up Tests with Machine Learning Algorithms

Wang

Chen

Shi

et al. 2020

Cancers

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Background: Tumor markers are used to screen tens of millions of individuals worldwide at annual health check-ups, especially in East Asia. Machine learning (ML)-based algorithms that improve the diagnostic accuracy and clinical utility of these tests can have substantial impact leading to the early diagnosis of cancer. Methods: ML-based algorithms, including a cancer screening algorithm and a secondary organ of origin algorithm, were developed and validated using a large real world dataset (RWD) from asymptomatic individuals undergoing routine cancer screening at a Taiwanese medical center between May 2001 and April 2015. External validation was performed using data from the same period from a separate medical center. The data set included tumor marker values, age, and gender from 27,938 individuals, including 342 subsequently confirmed cancer cases. Results: Separate gender-specific cancer screening algorithms were developed. For men, a logistic regression-based algorithm outperformed single-marker and other ML-based algorithms, with a mean area under the receiver operating characteristic curve (AUROC) of 0.7654 in internal and 0.8736 in external cross validation. For women, a random forest-based algorithm attained a mean AUROC of 0.6665 in internal and 0.6938 in external cross validation. The median time to cancer diagnosis (TTD) in men was 451.5, 204.5, and 28 days for the mild, moderate, and high-risk groups, respectively; for women, the median TTD was 229, 132, and 125 days for the mild, moderate, and high-risk groups. A second algorithm was developed to predict the most likely affected organ systems for at-risk individuals. The algorithm yielded 0.8120 sensitivity and 0.6490 specificity for men, and 0.8170 sensitivity and 0.6750 specificity for women. Conclusions: ML-derived algorithms, trained and validated by using a RWD, can significantly improve tumor marker-based screening for multiple types of early stage cancers, suggest the tissue of origin, and provide guidance for patient follow-up.

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Half-Life of Serum Alpha-Fetoprotein

Cited by 21 publications

References 27 publications

Human U Three Protein 14a Expression is Increased in Hepatocellular Carcinoma and Associated with Poor Prognosis

Human U Three Protein 14a Expression is Increased in Hepatocellular Carcinoma and Associated with Poor Prognosis

Propensity Score Matching Analysis of Changes in Alpha-Fetoprotein Levels after Combined Radiotherapy and Transarterial Chemoembolization for Hepatocellular Carcinoma with Portal Vein Tumor Thrombus

Improving Multi-Tumor Biomarker Health Check-Up Tests with Machine Learning Algorithms

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