9. Features of AFP expression level at different stages and gradations of hepatocellular carcinoma, correlation analysis between serum AFP
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Abstract
Hepatocellular carcinoma (HCC) is a malignant tumor of the liver which accounts for up to 90% of all liver cancers. In recent years, there has been an increase in the incidence of HCC all over the world, including in Kazakhstan. Diagnostic issues are still important. Alpha-fetoprotein (AFP) is a specific marker most widely used in the diagnosis of HCC. The article describes of the features of the AFP expression level in immunohistochemical studies with different stages and gradation of hepatocellular carcinoma, as well as a correlation analysis with serum AFP.
Material and methods. A total of 50 patients with HCC were analyzed. Blood serum tests were performed to determine the level of AFP and an IHC study to assess the expression of AFP.
Results. When analyzing the serological AFP, it was found that in the vast majority of cases (n=33), values were between 10-20 units/ml. In 83% cases HCC, cytoplasmic and nuclear expression of AFP was determined in malignant cells in IHC. The expression of the AFP was high in 32% cases, moderate in 46% cases, and low or not detected in 22% cases. The area of AFP - immunopositive cells node averaged 37.25±15.47%. When conducting a correlation analysis, it was found that the overall Pearson correlation coefficient between serum AFP and the degree of AFP staining was r = +0.0089.
Conclusion. Critically high AFP values correlate with the degree of HCC differentiation. The results of IHC showed that in 83% of patients with HCC, cytoplasmic and nuclear expression of AFP, which indicates a high sensitivity of the marker regarding the definition of malignancy. Given the absence of a correlation, it can be assumed that the serum AFP value cannot be associated with AFP expression data in immunohistochemistry and can be used as a separate value for HCC differentiation.
Keywords
hepatocellular carcinoma, serum alpha-fetoprotein, immunohistochemistry, stage
References
- World Health Organization. Cancer. Accessed 16 April 2017. http://www.who.int/ mediacentre/factsheets/fs297/en/
- European Association For The Study of the Liver; European Organization For Research And Treatment Of Cancer. EASLE ORTC clinical practice guidelines: management of hepatocellular carcinoma. J Hepatol 2012; 56:908–943. PMID:22424438. DOI:10.1016/j.jhep.2011.12.001[IndexedforMEDLINE]
- Masao Omata, Ann-Lii Cheng, Norihiro Kokudo et al. Asia–Pacific clinical practice guidelines on the management of hepatocellular carcinoma: a 2017 update. Hepatol Int 2017; 11:317–370. PMCID: PMC5491694 DOI:10.1007/s12072-017-9799-9[IndexedforMEDLINE]
- F.Bray; J.Ferlay; I.Soerjomataram et al. Global Cancer Statistics 2018: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA CANCER J CLIN 2018;68:394–424. PMID: 30207593, DOI:10.3322/caac.21492[IndexedforMEDLINE]5.GlobalCancerStatistics2018:GLOBOCAN,https://gco.iarc.fr/today/home
- McGlynn KA, London WT. Epidemiology and natural history of hepatocellular carcinoma. Best Pract Res Clin Gastroenterol. 2005 Feb;19(1):3-23. PMID: 15757802 DOI:10.1016/j.bpg.2004.10.004[IndexedforMEDLINE]
- Edamoto Y, Hara A, Biernat W, et al. Alterations of RB1, p53 and Wnt pathways in hepatocellular carcinomas associated with hepatitis C, hepatitis B and alcoholic liver cirrhosis. Int J Cancer. 2003 Sep1;106(3):334-41. PMID: 12845670 DOI:10.1002/ijc.11254[IndexedforMEDLINE]
- Bosetti C, Turati F, La Vecchia C. Hepatocellular carcinoma epidemiology. Best Pract Res Clin Gastroenterol. 2014; 28: 753-770. PMID: 25260306 DOI:10.1016/j.bpg.2014.08.007[IndexedforMEDLINE]
- Issamatov B.K., Baimakhanov B.B., Zholdybay Zh.Zh., Medeubekov U.Sh., Chormanov A.T., Tajibaev T.K., Kaniev Sh.A., Sagatov I.Y., Moskalenko N.I., Shmonin V.M. «Statistical indicators analysis of primary liver cancer in the Republic of Kazakhstan»
- Kulik LM, Chokechanachaisakul A. Evaluation and management of hepatocellular carcinoma. Clin Liver Dis. 2015; 19: 23-43. PMID: 25454295 DOI:10.1016/j.cld.2014.09.002[IndexedforMEDLINE]
- SHchegolev AI, Mishnyov OD Rol’ immunogistohimicheskogo issledovaniya dlya diagnostiki gepatocellyulyarnoj karcinomy // Mezhdunarodny jzhurnal prikladnyh I fundamental’nyh issledovanij = International Journal of Applied and Basic Research. 2017; 2:37 – 41 (In Russ)
- Tuffakha MS, Hychka SG , Husky GL. Immunohistochemical diagnosis of tumors [Immunokhistokhimicheskaya diagnostika opukholej]. Kyiv: Intermed; 2013.P. 223
- Rodionov SYu, Cherkasov VA, Malyutina NN, Orlov OA, (2004) Alfa-fetoprotein [Alfa-fetoprotein]. Ekaterynburh: UrO RAN; 2004. P 376. 13. 14. Johnson PJ: Role of alpha-fetoprotein in the diagnosis and management of hepatocellular carcinoma. J GastroenterolHepatol 1999, 14: 32 – 36. PMID: 0382636 DOI:10.1046/j.1440-1746.1999.01873.x[IndexedforMEDLINE]
- Kateishi R, Yoshida H, Matsuyama Y, Mine N, Kondo Y, Omata M: Diagnostic accuracy of tumor markers for hepatocellular carcinoma: a systematic review. Hepatol Int. 2008, 2: 17–
- Yuen MF, Lai CL. Serological markers of liver cancer. Best Pract Res ClinGastroenterol. 2005; 19:919. PMID:15757806. DOI:10.1016/j.bpg.2004.10.003[IndexedforMEDLINE]
- PMID: 20827404. doi:10.1007/s12072-010-9165-7