Low alpha-fetoprotein HCC

Brian I. Carr M.D. F.R.C.P., Ph.D. 1,*, Petr Pancoska Ph.D. 2, Robert A. Branch M.D. 2

Article first published online: 25 FEB 2010
DOI: 10.1111/j.1440-1746.2010.06303.x
Journal of Gastroenterology and Hepatology
Accepted Article (Accepted, unedited articles published online for future issues)

Author Information
1 Liver Tumor Program of Kimmel Cancer Center, Thomas Jefferson University, Philadelphia,
2 Center for Clinical Pharmacology, University of Pittsburgh.
* Correspondence: Brian I. Carr M.D., F.R.C.P., Ph.D. Liver Tumor Program, Kimmel Cancer Center, Thomas Jefferson University, Bluemle building, room 519, 233 S.10th Street, Philadelphia, PA 19107 Tel: 215 503 8842 Fax: 215 503 8755 E-mail: brian.carr@jefferson.edu

Keywords: low AFP;HCC;survival;GGTP;tumor size

Abstract

BACKGROUND: A large proportion of HCC patients do not secrete elevated levels of the tumor marker alpha-fetoprotein. There is little published guide to prognostic features of this patient subset. METHODS: We interrogated a large HCC database in which all patients had been followed till death, to examine which features might be prognostically useful. RESULTS: We found 413 biopsy-proven unresectable HCC patients with low serum AFP values. Serum GGTP levels were one of the most significant factors for survival. This dichotomization into low and high GGTP levels separated the patients into distinctive survival ranges. Patients with GGTP levels <110 U/100 ml and small tumors had longest survival >795 days. Patients with GGTP ≥110 U/ml and large tumors with presence of PVT had the shortest survival range of 300-560 days. CONCLUSIONS: Serum levels of the onco-fetal protein GGTP represent a useful prognostic parameter in HCC patients with low AFP levels.

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