DIAGNOSTIC VALUE OF ALPHA-FETOPROTEIN IN PROGRESSION OF HEPATIC CIRRHOSES OF VARIOUS ETIOLOGIES

Abstract

Aim. To determine the diagnostic value of alpha-fetoprotein (AFP) in progression of hepatic cirrhoses (HC) of various etiologies. Materials and methods. Seventy patients with hepatic cirrhosis including 49 patients with a viral etiology of this disease, 11 persons with alcoholic genesis and 10 patients with mixed cirrhosis (virus+alcohol) were examined. The group of control joined 10 practically healthy subjects. Blood serum alpha-fetoprotein level was assessed. Results. The serum AFP level was elevated in HC patients irrespective of etiology, as compared to the control group ( p < 0,001), it directly correlated with the degree of severity by Child-Pugh scale ( r = 0,35; p = 0,004). AFP level in patients with viral and mixed HC was significantly higher than in patients with alcoholic genesis of disease ( p = 0,03 and p = 0,03, respectively). AFP level in patients with compensated stage of HC ( n = 21) was 2,39 (1,16-6,79) ME/ml, with subcompensated ( n = 23) - 2,85 (2,1-18,6) ME/ml ( p = 0,18). In patients with decompensated HC ( n = 26), AFP was 5,02 (3,2-29,6) ME/ml that was significantly higher than in classes A and B ( p = 0,01 and p = 0,02, respectively). Conclusions. Higher AFP values were registered in patients with mixed genesis HC; AFP level rises as HC grows progressively worse; it permits to diagnose the decompensation of this process.

Keywords

Hepatic cirrhosis / alpha-fetoprotein / viral cirrhosis / alcoholic cirrhosis

References

[1] Белавина И.А., Дуданова О.П. Роль альфа-фетопротеина в комплексной диагностике прогрессирующего течения хронических гепатитов В и С. Российский журнал гастроэнтерологии, гепатологии, колопроктологии 2012; 3: 57-62.

[2] Рачковский М.И., Черногорюк Г.Э., Белобородова Е.В., Калачева Т.П., Шаловай А.А. Оценка прогностической роли альфа-фетопротеина при циррозе печени: результаты 3-летнего наблюдения. Фундаментальные исследования 2013; 9 (2): 724-728.

[3] Шкуро А.В. Прогностическое значение определения онкологических маркеров при вирусном гепатите C: автореф. дис. … канд. мед. наук. СПб. 2004; 24.

[4] Chen C.H., Lin S.T., Kuo C.L., Nien C.K. Clinical significance of elevated alpha-fetoprotein (AFP) in chronic hepatitis C without hepatocellular carcinoma. Hepatogastroenterology 2008; 85 (55): 1423-1427.

[5] Child C.G., Turcotte J.G. Surgery and portal hypertension. The liver and portal hypertension. Philadelphia: W.B. Saunders Co. 1964; 50.

[6] El-Serag Hashem B., Kanwal F., Davila J.A., Kramer J., Richardson P. A New laboratory-based algorithm to predict development of hepatocellular carcinoma in patients with hepatitis C and cirrhosis. Gastroenterology 2014; 5 (146): 1249-1255.

[7] Hu K.-Q., Kyulo N.L., Lim N. Clinical significance of elevated alpha-fetoprotein (AFP) in patients with chronic hepatitis C, but not hepatocellular carcinoma. Am J Gastroenterology 2004; 5 (99): 860-865.

[8] Li C., Zhang Z., Zhang P., Liu J. Diagnostic accuracy of des-gamma-carboxy prothrombin versus α-fetoprotein for hepatocellular carcinoma: a systematic review. Hepatol Res 2014; 44: 11-25.

[9] Pugh R.N.Н., Murray-Lyon I.M., Danson J.L. Transection of the oesophagus for bleeding oesophageal varices. Brit J Surg 1973; 8 (60): 646-648.

[10] Tai W.C., Hu T.H., Wang J.H. Clinical implications of alpha-fetoprotein in chronic hepatitis C. J Formos Med Assoc 2009; 3 (108): 210-218.

RIGHTS & PERMISSIONS

Paducheva S.V.