1. Ethnicity affects the diagnostic validity of alpha-fetoprotein in hepatocellular carcinoma
- Author
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Abd el-Raoof el-Deeb, Amro Abbas, Ahmed Sanny, Tetsuya Ichijo, Takashi Ehara, Takeji Umemura, Khalil Ali, Kaname Yoshizawa, Amal Gad, Akihiro Matsumoto, Eiji Tanaka, Xiaohong Sun, Abd el-Hamid Serwah, Fawzy Attia, Adel A Hassan, and Kendo Kiyosawa
- Subjects
HBsAg ,medicine.medical_specialty ,Cirrhosis ,business.industry ,Bilirubin ,Cancer ,General Medicine ,medicine.disease ,Gastroenterology ,digestive system diseases ,chemistry.chemical_compound ,Oncology ,chemistry ,Internal medicine ,Hepatocellular carcinoma ,Vitamin K deficiency ,medicine ,business ,Alpha-fetoprotein ,neoplasms ,Tumor marker - Abstract
Introduction: Hepatocellular carcinoma (HCC) is the fourth most common cancer worldwide with a high morbidity and mortality. Alpha-fetoprotein (AFP) is considered the main tumor marker for HCC diagnosis, but the variation in its diagnostic validity among studies justifies further investigation of the underlying contributing factors. Ethnic difference could be one of the factors that has not been well studied. We aimed at investigating the ethnic difference in AFP validity between Egyptian (representing Arabic North African) and Japanese (representing Asian) for HCC diagnosis. Methods: Four cohorts with chronic liver diseases (CLD) were studied: 171 Egyptian (65 HCC/106 non-HCC), and 173 Japanese (45 HCC/128 non-HCC). Laboratory tests including serum AFP, protein-induced vitamin K deficiency or absence (PIVKA-II), alanine aminotransferase (ALT), total bilirubin, platelet count, HBsAg, anti-HCV, and HCV core antigen were conducted using standard commercially available assays. Results: A significantly higher sensitivity of AFP in Egyptian in comparison with Japanese for HCC diagnosis (99 vs 67%, P 20.5 ng/mL (P = 0.007), older age (>50 years) with an AFP level >26 ng/mL (P = 0.010), and cirrhosis with an AFP level >10.5 ng/mL (P = 0.014) were the independent risk factors for HCC. Conclusion: There is an ethnic variation in AFP validity between Egyptian and Japanese patients with a significantly lower sensitivity in the latter. Alpha-fetoprotein should not be the only marker used for screening HCC among Asian Japanese and younger age groups (
- Published
- 2005