Diagnostic Role of Tumor Markers for Hepatocellular Carcinoma in Liver Transplantation Candidates: An Analysis Using the Korean Organ Transplantation Registry Database.

Abstract

BACKGROUND This study analyzed pretransplant alpha-fetoprotein (AFP) and proteins induced by vitamin K absence or antagonist-II (PIVKA-II) in liver transplantation (LT) candidates. MATERIAL AND METHODS A total of 3,273 LT recipients enrolled at the Korean Organ Transplantation Registry were divided according to hepatocellular carcinoma (HCC) status and background liver disease, and AFP and PIVKA-II were compared. RESULTS In all patients, the median AFP and PIVKA-II were 6.3 ng/mL and 29 mAU/mL in the viable-HCC group and 3.3 ng/mL and 35 mAU/mL, respectively, in the no-HCC group (P<0.001 for AFP and p=0.037 for PIVKA-II). In patients with hepatitis B virus infection, they were 6.0 ng/mL and 26 mAU/mL in the HCC group and 3.2 ng/mL and 21 mAU/mL in the no-HCC group, respectively (P<0.001 and P<0.001). In patients with hepatitis C virus infection, they were 10.7 ng/mL and 37 mAU/mL in the HCC group and 2.6 ng/mL and 21 mAU/mL in the no-HCC group, respectively (P<0.001 and P=0.117). In alcoholic liver disease patients, they were 5.2 ng/mL and 61 mAU/mL in the HCC group and 6.4 ng/mL and 75 mAU/mL in the no-HCC group, respectively (P<0.001 and P=0.419). In patients with other diseases, they were 7.1 ng/mL and 32 mAU/mL in the HCC group and 3.3 ng/mL and 28 mAU/mL in the no-HCC group, respectively (P<0.001 and P=0.822). CONCLUSIONS The results of the present study indicate that pretransplant serum AFP and PIVKA-II were highly variably expressed in LT candidates with end-stage liver diseases; therefore, their values should be cautiously interpreted because their role in HCC diagnosis is limited.

• Authors: Woo-Hyoung Kang, Shin Hwang, Jong Man Kim, Kwang-Woong Lee, Dong Jin Joo, Young Kyoung You, Je Ho Ryu, Bong-Wan Kim, Donglak Choi, Dong-Sik Kim, Yang Won Nah
• Journal: Annals of transplantation (Ann Transplant) Vol. 27 Pg. e936937 (Sep 13 2022) ISSN: 2329-0358 [Electronic] United States
• PMID: 36097403 (Publication Type: Journal Article)

Chemical References

• Biomarkers, Tumor
• Protein Precursors
• alpha-Fetoproteins
• Prothrombin

Topics

• Biomarkers, Tumor
• Carcinoma, Hepatocellular
• Humans
• Liver Neoplasms
• Liver Transplantation
• Protein Precursors (metabolism)
• Prothrombin
• Registries
• Republic of Korea
• alpha-Fetoproteins (metabolism)