The Characteristics and Prognosis of Alpha-Fetoprotein and Des-Gamma-Carboxy Prothrombin Double-Negative Hepatocellular Carcinoma at Baseline in Higher BCLC Stages

Alpha-fetoprotein (AFP) and des-gamma-carboxyprothrombin (DCP) are widely used as tumor markers to diagnose hepatocellular carcinoma (HCC). Some advanced HCCs demonstrate neither AFP nor DCP. This study investigated the characteristics and prognosis of AFP (<20 ng/mL) and DCP (<40 mAU/ml) doub...

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Published inCancers Vol. 15; no. 2; p. 390
Main Authors Nagahara, Takakazu, Sugihara, Takaaki, Kihara, Takuya, Ikeda, Suguru, Hoshino, Yoshiki, Matsuki, Yukako, Sakaguchi, Takuki, Kurumi, Hiroki, Onoyama, Takumi, Takata, Tomoaki, Matono, Tomomitsu, Yamaguchi, Naoyuki, Isomoto, Hajime
Format Journal Article
LanguageEnglish
Published Switzerland MDPI AG 06.01.2023
MDPI
Subjects
alpha-fetoprotein
Biomarkers
des-gamma-carboxyprothrombin
Hepatitis B
Hepatitis C
Hepatocellular carcinoma
Histopathology
Liver cancer
Medical prognosis
Patients
Prognosis
Prothrombin
survival
Survival analysis
Tumor markers
Tumors
α-Fetoprotein
alpha-fetoprotein
hepatocellular carcinoma
des-gamma-carboxyprothrombin
survival
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Summary:Alpha-fetoprotein (AFP) and des-gamma-carboxyprothrombin (DCP) are widely used as tumor markers to diagnose hepatocellular carcinoma (HCC). Some advanced HCCs demonstrate neither AFP nor DCP. This study investigated the characteristics and prognosis of AFP (<20 ng/mL) and DCP (<40 mAU/ml) double-negative HCC (DNHC) in higher-stage HCC. Between April 2012 and March 2022, 419 consecutive patients were enrolled with newly diagnosed HCC and 372 patients were selected that were diagnosed by histopathology and/or imaging. AFP-negative, DCP-negative, and double-negative HCC were identified in 262 patients (70.4%), 143 patients (38.2%), and 120 patients (32.3%), respectively. In higher-BCLC stages (BCLC-B, C, and D), 17 patients (14.7%) were DNHC. Although there was no difference in BCLC staging, there were more cases under TNM Stage III in DNHC (71.0% vs. 41.4%, p = 0.026). The median maximum tumor diameter was smaller in DNHC [3.2 (1.8−5.0) vs. 5.5 (3.5−9.0) cm, p = 0.001] and their median survival time was significantly better, even in higher-stage HCC [47.0 (24.0−84.0) vs. 19.0 (14.0−30.0) months, p = 0.027). DNHC in higher-BCLC stage HCC is independent of BCLC staging, characterized by a tumor diameter < 5 cm, and is treatable with a good prognosis.
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These authors contributed equally to this work.
ISSN:2072-6694
2072-6694
DOI:10.3390/cancers15020390