Did AFP-L3 save ultrasonography in community screening?

In the community screening, those subjects with elevated serum alpha-fetoprotein (AFP) required further abdomen ultrasonography (US) to detect hepatocellular carcinoma (HCC). However, some chronic hepatitis patients might have elevated AFP. AFP-L3, has been proposed to differentiate HCC and hepatiti...

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Bibliographic Details
Published in:The Kaohsiung journal of medical sciences 2018-10, Vol.34 (10), p.583-587
Main Authors: Yen, Chih-Wei, Kuo, Yuan-Hung, Wang, Jing-Houng, Chang, Kuo-Chin, Kee, Kwong-Ming, Hung, Shu-Feng, Chen, Yi, Tsai, Lin-San, Chen, Shu-Chuan, Hung, Chao-Hung, Lu, Sheng-Nan
Format: Article
Language:English
Subjects:
Aged
Alpha-fetoprotein
Alpha-fetoprotein-L3
alpha-Fetoproteins - analysis
Biomarkers, Tumor - blood
Carcinoma, Hepatocellular - blood
Carcinoma, Hepatocellular - diagnosis
Carcinoma, Hepatocellular - diagnostic imaging
Community hepatocellular carcinoma screening
Diagnostic reagents industry
Hepatitis
Humans
Liver Neoplasms - blood
Liver Neoplasms - diagnosis
Liver Neoplasms - diagnostic imaging
Mass Screening - statistics & numerical data
Middle Aged
Retrospective Studies
Ultrasonography
Ultrasonography - statistics & numerical data
Ultrasound imaging
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Summary:In the community screening, those subjects with elevated serum alpha-fetoprotein (AFP) required further abdomen ultrasonography (US) to detect hepatocellular carcinoma (HCC). However, some chronic hepatitis patients might have elevated AFP. AFP-L3, has been proposed to differentiate HCC and hepatitis in elevated AFP cases in Japan for decades, but the utility is limited outside Japan. We conducted this study to elucidate the role of AFP-L3 in the community and the possibility of saving unnecessary US. A total of 56,702 subjects underwent a large-scale healthcare screening in Tainan county in 2004. Among them, 286 residents with AFP more than 20 ng/ml further received US and 169 (59%) had stored baseline sera were enrolled into this study in 2013. Their AFP and AFP-L3 levels were further detected. HCC patients were initially identified through US and personal history. Among 169 studied sera, only 148 (87.6%) samples still had AFP level more than 20 ng/ml after a 10-years frozen period. The decrease of AFP level was significant (481.3 ± 2093.8 ng/ml and 456.1 ± 2095.3 ng/ml in paired-T test, p 
ISSN:1607-551X
2410-8650
DOI:10.1016/j.kjms.2018.05.005