Serum alpha-fetoprotein levels in patients with advanced hepatitis C: Results from the HALT-C Trial
Serum alpha-fetoprotein levels in patients with advanced hepatitis C: Results from the HALT-C Trial
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DOI：
10.1016/j.jhep.2005.03.019
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发表时间：
2005-09-01
影响因子：
25.7
通讯作者：
Gretch, DR
中科院分区：
文献类型：
--
作者：
Di Bisceglie, AM;Sterling, RK;Gretch, DR
背景/目的：甲胎蛋白(AFP)已用于肝细胞癌的诊断，但缺乏特异性。我们评估了慢性丙型肝炎和晚期纤维化患者的血清AFP，以建立AFP升高和抗病毒治疗后变化的预测指标。方法：在丙型肝炎抗病毒长期治疗(HALT-C)的患者中，在基线和治疗时测定血清AFP。结果：在1145例患者中，191例(16.6%)的基线AFP<20 ng/mL。肝硬变患者的平均甲胎蛋白水平显著高于桥接性纤维化患者(22.5vs.11.4 ng/mL，P<；0.0001)。与肝硬变患者血清AFP升高有关的独立因素有女性、黑人、血小板减少、血清AST/ALT比值升高、血清铁蛋白和肝活检中的Mallory小体。在聚乙二醇化干扰素α-2a和利巴韦林治疗期间，血清AFP水平显著降低。有6例患者确诊为肝细胞癌，其中仅3例AFP>；20 ng/ml。结论：在慢性丙型肝炎晚期患者中，即使没有肝细胞癌，血清AFP水平也经常升高。与AFP升高相关的因素包括肝病严重程度、女性和黑人种族。血清甲胎蛋白水平在抗病毒治疗期间下降。(C)2005年欧洲肝脏研究协会。爱思唯尔出版，版权所有。
Background/Aims: Alpha-fetoprotein (AFP) has been useful in the diagnosis of hepatocellular carcinoma (HCC) but lacks specificity. We assessed serum AFP among patients with chronic hepatitis C and advanced fibrosis to establish predictors of AFP elevations and changes with antiviral therapy.Methods: Serum AFP was measured at baseline and on therapy in patients in the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C). AFP levels were correlated with patient demographic and clinical features.Results: Baseline AFP was >= 20 ng/mL in 191 of 1145 patients (16.6 %). Mean AFP values were significantly higher in patients with cirrhosis than in those with bridging fibrosis (22.5 vs. 11.4 ng/mL, P < 0.0001). Factors independently associated with raised serum AFP in patients with cirrhosis were female gender, black race, decreased platelet count, increased serum AST/ALT ratio, serum ferritin, and Mallory bodies in liver biopsies. Serum AFP levels decreased significantly during therapy with pegylated interferon alpha-2a and ribavirin. HCC was identified in six subjects, only three of whom had AFP > 20 ng/mL.Conclusions: Among patients with advanced chronic hepatitis C, serum AFP values are frequently elevated, even in the absence of HCC. Factors associated with raised AFP include severity of liver disease, female gender and black race. Serum AFP levels decline during antiviral therapy. (c) 2005 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.