IDDF2018-ABS-0137 Longitudinal assessment of alpha-fetoprotein, lectin-reactive alpha-fetoprotein, and des-gamma-carboxy prothrombin for the early detection of hepatocellular carcinoma

Background Few studies for biomarkers in hepatocellular carcinoma (HCC) have reported using prospectively collected longitudinal samples. Methods Among 689 patients who participated to four randomised trials for cirrhosis and/or chronic hepatitis B, 42 HCC cases were diagnosed during follow up, and 168 controls were matched for age, sex, aetiology, cirrhosis, and duration of follow-up in a 1:4 ratio. Samples at the time of HCC diagnosis, months −6, and month −12 were tested for alpha-fetoprotein (AFP), lectin-reactive AFP (AFP-L3), and des-gamma-carboxy prothrombin (DCP) in the HCC cases and controls. Results Of 42 cases with HCC, 39 (93%) had cirrhosis, 36 (85.7%) had normal alanine aminotransferase, and 31 (73.8%) had single HCC Conclusions AFP and AFP-L3 increased from 6 months before the diagnosis of early-stage HCC. AFP and AFP-L3 combination showed better performance than single biomarkers. Adopting a cutoff value of AFP level at 5 ng/mL would significantly increase the sensitivity for HCC detection.