Analysis of Alfa-Fetoprotein as A Staging Determiner of Hepatocellular Carcinoma Progresivity
DOI:
https://doi.org/10.24293/ijcpml.v29i3.2044Keywords:
Hepatocellular carcinoma, alpha-fetoprotein, Barcelona clinic liver cancerAbstract
Hepatocellular carcinoma (HCC) is the most common malignant tumor with a poor prognosis and is known as the silent killer. The currently recommended HCC staging system is Barcelona Clinic Liver Cancer (BCLC). The Alpha-fetoprotein (AFP) test is still used to manage HCC patients. The purpose was to find out the AFP comparations and to decide cut-off values for each stage according to BCLC. Cross-sectional retrospective study using secondary data from medical records of Outpatients Clinic and Inpatients from January 2016 to October 2021 at Dr. Wahidin Sudirohusodo Hospital. A total of 432 samples based on BCLC were taken with AFP values and analyzed in this study. The male sample was 72.7%. The highest age is 46-65 years (62.7%). The etiology of HCC mostly is hepatitis B (72.5%). The most BCLC systems were BCLC B (53.7%), followed by BCLC A (25.9%), BCLC D (12.5%), and BCLC C (7.87%). There was a significant difference in AFP values between BCLC stages and the highest significance was BCLC D, followed by BCLC C, B, and A (p=0.05). The cut-off results values at the BCLC stage were BCLC A <21.84 ng/mL, BCLC B: 21.84 ng/mL (sensitivity 90.3%, specificity 85.7%), BCLC C: 478 ng/mL (sensitivity and specificity 100%), BCLC D: 7.693 ng/mL (sensitivity and specificity 100%). There was a significant difference in AFP values between BCLC stages and the highest is BCLC D. Based on the results of calculating the cut-off value, which has good sensitivity and specificity, AFP can be used as a determinant of stage progression of HCC.
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References
Budihusodo. Karsinoma Hati. Buku Ajar Ilmu Penyakit Dalam. Ed VI., Jilid I, Jakarta, FKUI, 2018; 3040-9.
Santosa IPA, Djatmiko DP, Lawanto ER, Pratomo B, Susianti H. Diagnostic test of PIVKA-II as a tumor marker for hepatocellular carcinoma. Indonesian Journal of Clinical Pathology and Medical Laboratory, 2020; 26(2): 142-145.
Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin, 2020; 1-6.
Liu Z, Xu K, Jiang Y, Cai N, Fan J, et al. Global trend of etiology-based primary liver cancer incidence from 1990 to 2030: A modeling study. Int. J. Epidemiol, 2021; 128–142.
Fadillah D, Prihantono. Insidensi penyakit kanker di RSUP. Dr. Wahidin Sudirohusodo Makassar periode Januari 2015-Juni 2017. Skripsi, 2017; 6-8.
Marrero JA, Kulik LM, Sirlin CB, Zhu AX, Finn RS, et al. Diagnosis, staging, and management of hepatocellular carcinoma: Practice guidance by the American Association for the study of liver diseases. Journal of Hepatology, 2018; 68(2): 723–50.
Mauss S, Berg T, Rockstroh J, Sarrazin C, Wedemeyer H. Hepatocellular carcinoma. Hepatology a clinical textbook. 10th Ed., Germany, Spengler, 2020; 506-9.
Zhang N, Gu J, Yin L, Wu J, Ming-yu Du, Ding K, et al. Incorporation of alpha-fetoprotein (AFP) into subclassification of BCLC C stage hepatocellular carcinoma according to a 5-year survival analysis based on the SEER database. Oncotarget, 2017; 7(49): 81389–401.
Muhammad NA, Muhammad KH, Omer Nasim, Muhammad AA, Muhammad SF, Zeinab H. Correlation of serum alpha-fetoprotein (AFP) and tumor size of hepatocellular carcinoma (HCC) in tertiary care hospital of Peshawar. Journal of Rahman Medical Institute, 2020; 6(3): 12-5.
Gomez-Rodriguez R, Romero-Gutierrez M, Artaza-Varasa T, Gonzalez-Frutos C, Ciampi-Dopazo JJ, et al. The value of the Barcelona clinic liver cancer and alpha-fetoprotein in the prognosis of hepatocellular carcinoma. Rev Española Enfermedades Dig, 2017; 104(6): 298–304.
11. Zheng Y, Zhu M, Li M. Effects of alpha fetoprotein on the occurrence and progression of hepatocellular carcinoma. Journal of Cancer Research and Clinical Oncology (China, Hainan Medical College), 2020; 4: 539-546.
Jasirwan COM, Fahira A, Siregar L, Loho I. The alpha-fetoprotein serum is still reliable as a biomarker for the surveillance of hepatocellular carcinoma in Indonesia. BMC Gastroenterol, 2020; 20(1): 1–8.
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