This article reviews the lights and shadows of AFP as a surveillance test for patients at risk of HCC, and as a diagnostic test for those with chronic liver disease and a suspected hepatic mass.
Multivariable analysis revealed that rim arterial phase hyperenhancement [odds ratios (ORs) = 13.16], biliary dilation (OR = 23.42) and CA19-9 (OR = 21.45) were significant predictors of large IMCCs (n = 138), and washout appearance (OR = 0.036), enhancing capsule appearance (OR = 0.039), fat in mass (OR = 0.057), chronic liver disease (OR = 0.088) and alpha fetoprotein (OR = 0.019) were more frequently found in large HCCs (n = 143).
We assessed the diagnostic performances of alpha-fetoprotein (AFP) and protein-induced by vitamin-K-absence/antagonist-II (PIVKA-II) in 388 cirrhotic patients with chronic liver disease (CLD).
Area under receiver operating characteristics curves in distinguishing HCC from chronic liver disease (CLD; CH and LC) were 0.782 (95% CI; 0.729-0.834) for OPN and 0.888 (95% CI; 0.850-0.927) for AFP.
The absence of detectable responses in healthy donors and patients with chronic liver disease suggests that AFP-specific CD4(+) T cells in the responder patients had been previously expanded in vivo in response to the tumor.