An US image of the liver shows a 2 cm solid nodule in a cirrhotic liver.
CT images of the liver in arterial and portovenous phases show arterial contrast enhancement with rapid washout of the nodule.
Facts: Serum AFP & Hepatocellular Carcinoma (HCC)
- First detection of AFP in serum of HCC patients in 1970s
- Currently, it is the only widely used serologic marker for diagnosing HCC. Additional useful markers in use are AFP-L3 and DCP
- Normal range 10-20 ng/mL
- AFP greater than 400 ng/mL generally considered a point of discriminating HCC from other chronic liver disease
- Problem: about 60% of patients with HCC have AFP below 200, up to 20% have normal AFP (AFP-negative HCC; AFP below 20)
Clinical Features of AFP-negative HCC
- Less likely to be hepatitis B positive
- Tend to have a lower level of ratio of serum glutamic oxaloacetic transaminase (AST)/pyruvic transaminase (ALT)
1. Law WY. Hepatocellular Carcinoma, 2007.
2. Nomura F, Ohnishi K, Tanabe Y. Clinical features and prognosis of hepatocellular carcinoma with reference to serum alpha-fetoprotein levels. Analysis of 606 patients. Cancer 1989;64:1700-1707.