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BACKGROUND Prothrombin induced by vitamin K absence or antagonist-II (PIVKA-II) and alpha fetoprotein (AFP) are biomarkers for hepatocellular carcinoma (HCC). However, their performance in patients with cirrhosis related to hepatitis C virus (HCV) treated with direct-acting antiviral agents (DAA) is unknown. AIM To evaluate PIVKA-II and AFP as HCC predictors in DAA-treated patients with HCV-related cirrhosis METHODS: In this single centre study, patients with cirrhosis from chronic HCV infection and with a sustained virological response (SVR) to DAA were tested for PIVKA-II and AFP (Fujirebio, Japan) at the start of DAA treatment (baseline), end of treatment (EOT) and at HCC diagnosis. RESULTS We included 400 patients with mean age 65 (24-92); 56% were men. From baseline to EOT, PIVKA-II did not change (35 vs 35 mAU/mL, P = 0.43) while AFP significantly decreased (12 vs 6 ng/mL, P or ≤41 mAU/mL (P or ≤15 ng/mL (P = 0.02). By combining EOT-PIVKA-II and AFP, the 4-year probabilities of HCC were 3% in patients testing negative for both markers, 18% in patients positive for both, and 38% in patients positive for at least one (P

Liver transplantation (LT) is a validated treatment for selected cirrhotics with hepatocellular cancer (HCC). A retrospective single center study including 137 recipients having proven HCC was done to refine inclusion criteria for LT as well as to look at impact of locoregional treatment (LRT) on outcome. At pre-LT imaging, 42 (30.6%) patients were Milan criteria (MC)-OUT; 28 (20.4%) were University of California San Francisco criteria (UCSFC)-OUT. Pre-LT LRT was performed in 109 (79.6%) patients. Multivariate analysis identified four factors to be independently predictive of recurrence: tumour number >3, AFP level ≥400 ng/ml, microvascular invasion and rejection needing anti-lymphocytic antibodies. When considering pre-transplant variables only, AFP level ≥400 ng/ml (HR = 5.13; P

Content: Prelabour rupture of membranes (PROM) complicates overall 10% of gestations which include 7% at term and 3 % preterm gestations. Making an early and accurate diagnosis of PROM is important, to allow gestational age specific obstetric interventions and to optimize perinatal outcome. Objective: To study the efficacy of alpha-foeto protein in cervicovaginal secretions, to diagnose prelabour rupture of membranes. Setting: A tertiary care centre. Materials and Methods: We performed a prospective study on 130 patients who were at ≥ 24 weeks of gestation, who had complaint of leaking per vagina, between September 2011 and August 2013. Alpha-foetoprotein test was perfomed on cervicovaginal secretions which were collected during per-speculum examinations. A diagnosis of prelabour rupture of membranes was made, based on combined clinical diagnosis which was made during hospital stay of the patients prospectively. The efficacy of Alpha-foetoprotein was studied. Stastical Analysis: Chi-square test, Kappa analysis. Results: The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of Alpha-foetoprotein were 88.9%, 98.5%, 98.3%, 90.1% and 93.8% respectively. Degree of agreement of Alpha-foetoprotein with combined clinical diagnosis was 0.875. Conclusion: Assessment of alpha-foetoprotein levels in cervi-covaginal secretions can be used as a reliable test to diagnose prelabour rupture of membranes when faced with a diagnostic dilemma.

Suppression of human α-foetoprotein-producing hepatocellular carcinoma growth in nude mice by an anti α-foetoprotein antibody-daunorubicin conjugate with a poly-L-glutamic acid derivative as intermediate drug carrier

This article reviews the value of the tumour markers alpha-foetoprotein (AFP) and human chorionic gonadotrophin (hCG) in the management of patients with testicular germ-cell tumours, especially non-seminomatous tumours. Recent developments in their use, such as metabolic decay rate analysis, are discussed. Possible new markers for testicular cancer, particularly SP-1 and placental alkaline phosphatase, are reviewed.

An analysis of survival time of 57 West European patients with hepatocellular carcinoma was carried out to define which of several possible factors (age, sex, cirrhosis and raised serum alpha-foetoprotein (AFP)) influenced survival. Although survival was significantly longer in younger patients (P less than 0.02) and in patients with normal serum AFP (P less than 0.01), multivariate analysis showed that significant variation in survival time is better explained by the single factor, the presence of cirrhosis, than by AFP level. This does not seem to apply for patients with this tumour in Africa and the Far East, and there may be a fundamental difference in the natural history of the tumour between high- and low-incidence areas.

Summary In the course of immunofluorescence absorption studies it was found that, besides Marek's disease tumour‐associated surface antigen (MATSA), two foetal antigens could be distinguished on MSB‐1 line cells, one of which was chicken foetal red blood cell antigen (chFRBC) and another chicken alpha‐foetoprotein (chAFP). The experiments suggest a lack of homology between the three antigens.

Female rats were maintained on standard laboratory diet, Miller's diet or Miller's diet containing 3'MeDAB. Animals fed standard or Miller's diet did not excrete alpha-foetoprotein (AFP) in their urine. Early appearance of AFP was demonstrated by examining the urine of rats on the 3'MeDAB regimen. The incidence of positive urine samples was high between the 5th and 7th week of the experiment. It thereafter declined, but from the 3rd month it steadily rose and reached a maximum of 80% at about 10 months. Though urinary excretion of AFP was irregular in individual animals, several positive urine samples were obtained from all rats followed for more than a few months. The urine of 90% of hepatoma-bearing rats contained AFP at the time of killing. The incidence of elevated serum AFP levels as determined by immunodiffusion, increased with the duration of the experiment, but was still only 70 percent in rats fed 3'MeDAB for over 34 weeks. The severity of the hepatic alterations, as well as hepatocytic uptake of [3H]thymidine, increased with time. The serum of animals fed the standard diet was negative, whereas AFP was very infrequently detected in the serum of rats given Miller's hypoprotein diet. The results demonstrate that, in a population exposed to hepatocarcinogenic agent, the recurring detection of urinary excretion of AFP is a useful indicator of the high risk of developing hepatomas. Images Fig. 2 Fig. 3 Fig. 5

Finnstrom, O., Gothefors, L. and Zetterlund, B. (Departments of Paediatrics, University Hospitals, Linkoping and Umea, Sweden). Studies on maturity in newborn infants. VII. Foetal haemoglobin. Acta Paediatr Scand, 64:404, 1975.–Cord blood from 125 newborns of various gestational ages has been analysed for the ratio foetal haemoglobin to total haemoglobin, using an alkali denaturation method. The quotient, percentage of foetal haemoglobin divided by birth weight correlates well with gestational age. Thus the percentage of foetal haemoglobin in cord blood can be used as a method for estimating maturity in newborn infants. Foetal haemoglobin has been compared with other methods for maturity assessments and seems to give the same precision in estimating gestational age as the best of these, which is the scoring of external characteristics. However, the latter method is considerably less time-consuming and more suitable for routine use.

Carbohydrate antigen 19-9 as a serum marker of hepatocellular carcinoma: Comparison with alpha-foetoprotein

α-FOETOPROTEiNS (AFP) have been observed in the serum of all mammalian species so far studied1,2. In the rabbit AFP constitutes about 33% of the total serum protein on day 20 of gestation and reaches a peak concentration around days 24 to 26 (ref. 3). This ontogenic pattern is similar to that of the rat where maximum concentration is also reached late in gestation, but differs from the human where a steady decline occurs after the first trimester4,5. Although considerable interest has attached to the reappearance of AFP in the serum of adult animals and human patients with hepatocellular cancer6–9, little attention has been given to the possible role of this protein in normal development. The preliminary experiments reported here were designed to investigate this aspect by selectively neutralising AFP in vivo with specific antibodies.

Lack of suppressive effect of α-foetoprotein on development of experimental allergic encephalomyelitis in rats

Fatty acid analysis of purified bovine alpha-foetoprotein showed it to contain 2.7 mol of fatty acid/mol of alpha-foetoprotein. Purified alpha-foetoprotein focused at isoelectric point 4.8. Removal of bound ligands from alpha-foetoprotein by charcoal treatment changed its isoelectric point to 5.2. This change could be reversed by addition of exogenous fatty acids to the defatted alpha-foetoprotein. Albumin isolated from the same foetal calf serum source as alpha-foetoprotein contained 1.4 mol of fatty acid/mol of protein. alpha-Foetoprotein and albumin contained comparable amounts of fatty acids with 14 to 18 carbon atoms, but alpha-foetoprotein contained 16 times as much of the long-chain polyunsaturated fatty acids as albumin. alpha-Foetoprotein was found to have slightly higher affinity for palmitate and linoleate and severalfold higher affinity for arachidonate than albumin. These findings suggest that alpha-foetoprotein may play a role in the foetal metabolism of the long-chain polyunsaturated fatty acids.

α-FoETOPROTEiN (AFP) is one of the main proteins of embryonic serum. Its synthesis begins in the yolk sac continues in embryonic liver and terminates in mice and rats at the beginning of the postnatal period1,2. Presumably a powerful suppression factor acts on AFP production by embryonic liver cells after the embryonic period has finished. The present study was undertaken to determine this factor(s).

ABOUT 1000of testicular germ-cell tumoursoccurinmen treated formaldescended testes(Whitaker, 1970). The risk oftesticular tumourinmenwithmaldescended testes hasbeenestimated at35 timesthatofnormalmen (Whitaker, 1970). Recently 2 case-control studies confirmed theincreased riskoftesticular tumourinmaldescended testes (Morrison, 1976;Henderson etal., 1979). Testicular germ-cell (TGC) tumoursmaybepreceded bycarcinoma insituinabiopsy several yearsbefore(Skakkebaek, 1972,1978). Raisedconcentrations ofserumo-foetoprotein (AFP)andserumhumanchorionic gonadotropin :subunit (hCG)often precededothersignsofrelapse innonseminomatous TGC tumours(Waldmann &McIntire, 1974). SerumAFP and serum hCG were measured asascreen forTGCtumoursin menwithmaldescended testes, inaddition tophysical examination andtesticular biopsy. Thehistological findings ofthe first 50menbiopsied haverecently been reported elsewhere (Krabbe etal., 1979). Inthis paperwereport theresults ofthe tumourmarkers. Twohundred andseventy men aged18to35yearswhohadbeen treated formaldescended testeswere askedbyletter totakepartinthestudy. During childhood theyhadeither orchido

THE use of immunochemical methods for studying the composition of foetal human blood serum proteins led to the discovery of, in addition to the known alpha foetoprotein1–8, other embryospecific globulins with electrophoretic mobility of beta1 (refs. 5, 6, 9) and beta2 globulins9. Alpha foetoprotein is a relatively constant component of foetal blood serum. Embryospecific beta1 globulin was discovered in about 75 per cent9,10 and embryospecific beta2 globulin in 50 per cent of the cases9.