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Huang D, Zhang J, Xu J, Niu Q, Zhou D. Utility of Alpha-Fetoprotein and Ultrasound in the Diagnosis and Prognosis of Patients with Hepatocellular Liver Cancer. J Multidiscip Healthc 2024; 17:1819-1826. [PMID: 38680882 PMCID: PMC11055514 DOI: 10.2147/jmdh.s449276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2023] [Accepted: 04/04/2024] [Indexed: 05/01/2024] Open
Abstract
Objective To investigate the utility of alpha-fetoprotein (AFP) and ultrasound in the diagnosis and prognosis of patients with hepatocellular liver cancer (HCC). Methods Using retrospective convenience sampling, 401 patients with HCC who underwent transarterial chemoembolisation at the Department of Oncology of The Affiliated Huaian No.1 People's Hospital of Nanjing Medical University between June 2015 and January 2020 were recruited and assigned to the case group. Simultaneously, patients matched to the case group in terms of gender and age but excluded for HCC were enrolled at a 1:1 ratio and classified as the control group. Relevant parameters were collected from both groups for comparison. Results Both AFP levels and ultrasound results demonstrated diagnostic value for patients with HCC (P < 0.05). Their combined use exhibited the highest diagnostic accuracy for the cancer, with an area under the curve of 0.896 (95% confidence interval [CI]: 0.876, 0.923), a sensitivity of 67.65% and a specificity of 91.22%. In terms of overall survival (OS), statistically significant differences in the OS rates were observed between the low-AFP (L-AFP) group and high-AFP (H-AFP) group as well as between the low-tumour-diameter (LTD) group and high-tumour-diameter (HTD) group (81.31% vs 52.22% and 85.11% vs 63.41%, respectively; P < 0.05). Regarding the progression-free survival (PFS), significant differences in the PFS rates were also noted between the L-AFP and H-AFP groups and between the LTD and HTD groups (81.31% vs 52.22% and 85.11% vs 63.41%, respectively; P < 0.05). Conclusion Ultrasound and AFP display notable distinctions when used in the diagnosis of HCC. The sensitivity of ultrasound as a standalone diagnostic tool surpasses that of AFP alone. However, their combined use results in much higher specificity than the use of either test individually. In addition, both techniques hold predictive value for patients' OS and PFS, enabling timely prognostic assessment.
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Affiliation(s)
- Dongfang Huang
- Department of Hepatobiliary Surgery, Medical College of Soochow University, Suzhou, People’s Republic of China
- Department of Hepatobiliary Surgery, PLA Rocket Force Characteristic Medical Center, Beijing, People’s Republic of China
- Department of Hepatobiliary Surgery, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huaian, People’s Republic of China
| | - Jianhuai Zhang
- Department of Hepatobiliary Surgery, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huaian, People’s Republic of China
| | - Jianbo Xu
- Department of Hepatobiliary Surgery, The Affiliated Huaian No.1 People’s Hospital of Nanjing Medical University, Huaian, People’s Republic of China
| | - Qiang Niu
- Department of Hepatobiliary Surgery, PLA Rocket Force Characteristic Medical Center, Beijing, People’s Republic of China
| | - Dinghua Zhou
- Department of Hepatobiliary Surgery, PLA Rocket Force Characteristic Medical Center, Beijing, People’s Republic of China
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Tuoya AD, Wang DX, Xing YS, Liu RJ, Hu YX, Zhang MD, Bai TY, Lv XL, Li J, Chang FH. Relationship between Methylation of FHIT and CDH13 Gene Promoter Region and Liver Cancer. Curr Med Sci 2020; 40:502-509. [PMID: 32474857 DOI: 10.1007/s11596-020-2202-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2019] [Revised: 04/04/2020] [Indexed: 01/27/2023]
Abstract
In order to demonstrate the relationship between methylation of fragile histidine triad (FHIT) and T-cadherin/H-cadherin (CDH13) genes and liver cancer, the methylation status of FHIT and CDH13 was detected in healthy individuals and in Mongolian and Han patients with liver cancer. The phenol-chloroform method was used to extract genomic DNA. The methylation specific polymerase chain reaction method was applied to detect the methylation status of FHIT and CDH13. The relationship between smoking and alcohol consumption and gene (FHIT and CDH13) methylation was analyzed. There was significant difference in methylation rate of FHIT (72.67%, 34.67%) and CDH13 (72.0%, 28.0%) between liver cancer patients and healthy individuals of Mongolian descent (P<0.05), as well as that of FHIT (68%, 30.67%) and CDH13 (64%, 26%) between liver cancer patients and healthy individuals of Han individuals (P<0.05). There was also a relationship between smoking and drinking and the methylation of FHIT and CDH13 (P<0.05). Thus, the methylation of FHIT and CDH13 had a relationship with liver cancer incidence. Smoking and alcohol ingestion may promote the methylation of FHIT and CDH13.
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Affiliation(s)
- Ao-Dun Tuoya
- The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010010, China
| | - Dong-Xue Wang
- Department of Pharmacology of Pharmaceutical College, Inner Mongolia Medical University, Hohhot, 010010, China
| | - Yu-Shu Xing
- The Center for New Drug Safety Evaluation and Research of Inner Mongolia Medical University, Hohhot, 010010, China.,Inner Mongolia Research Center for Drug Screening, Hohhot, 010110, China
| | - Rui-Jun Liu
- The Affiliated Hospital of Inner Mongolia Medical University, Hohhot, 010010, China
| | - Yu-Xia Hu
- The Center for New Drug Safety Evaluation and Research of Inner Mongolia Medical University, Hohhot, 010010, China.,Inner Mongolia Research Center for Drug Screening, Hohhot, 010110, China
| | - Meng-di Zhang
- Department of Pharmacology of Pharmaceutical College, Inner Mongolia Medical University, Hohhot, 010010, China.,Inner Mongolia Research Center for Drug Screening, Hohhot, 010110, China
| | - Tu-Ya Bai
- Department of Pharmacology of Pharmaceutical College, Inner Mongolia Medical University, Hohhot, 010010, China.,Inner Mongolia Research Center for Drug Screening, Hohhot, 010110, China
| | - Xiao-Li Lv
- Department of Pharmacology of Pharmaceutical College, Inner Mongolia Medical University, Hohhot, 010010, China.,Inner Mongolia Research Center for Drug Screening, Hohhot, 010110, China
| | - Jun Li
- Inner Mongolia Research Center for Drug Screening, Hohhot, 010110, China
| | - Fu-Hou Chang
- Department of Pharmacology of Pharmaceutical College, Inner Mongolia Medical University, Hohhot, 010010, China. .,The Center for New Drug Safety Evaluation and Research of Inner Mongolia Medical University, Hohhot, 010010, China. .,Inner Mongolia Research Center for Drug Screening, Hohhot, 010110, China.
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Only one-third of hepatocellular carcinoma cases are diagnosed via screening or surveillance: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol 2020; 32:406-419. [PMID: 31490419 DOI: 10.1097/meg.0000000000001523] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND/OBJECTS Early hepatocellular carcinoma diagnosis is associated with better long-term survival. Studies of at-risk patients who are monitored in routine practice have reported an overall adherence rate to hepatocellular carcinoma screening/surveillance of approximately 60% and suboptimal diagnostic efficacy of the current screening/surveillance tools. However, it is unclear how many hepatocellular carcinoma patients were actually diagnosed via screening/surveillance given these obstacles. Therefore, via a systematic review of PubMed and Scopus databases from 2000 to 2019, we aimed to identify the proportion of patients with hepatocellular carcinoma diagnosed via screening/surveillance in routine practice. METHODS We included original research articles of studies of patients already diagnosed with hepatocellular carcinoma that reported the proportion of hepatocellular carcinoma diagnosed via screening/surveillance. RESULTS The study included 60 studies and 50 554 hepatocellular carcinoma cases. The pooled proportion of hepatocellular carcinoma diagnosed by screening/surveillance was 37% (95% confidence interval: 31%-44%) and differed by geographic region (North America/Asia/Europe/Oceania/Africa/South America, 31%/42%/41%/30%/29%/47%, P = 0.017, respectively) and by surveillance interval (<12 months 39% vs. 12 months 19%, P < 0.01) but not by disease etiology, cirrhosis status, clinical setting, practice setting, hepatocellular carcinoma diagnosis period, or surveillance method. CONCLUSION Globally, hepatocellular carcinoma was diagnosed via screening/surveillance in less than half of the patients (37%) regardless of healthcare setting or liver disease etiology and without improvement over time despite several recent guideline updates. Research is needed to understand the barriers to screening/surveillance to include medical as well as social and cultural influences.
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