• Journal of Gastric Cancer
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• v.3 no.1
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• pp.33-37
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• 2003

Purpose: Alpha-fetoprotein (AFP) is widely accepted as a useful tumor marker for diagnosis of hepatocellular carcinomas. On rare occasions, however, an abnormal elevation of serum AFP also has been reported in an adenocarcinoma of the gastrointestinal tract. We evaluated the influence of preoperative abnormal elevation of serum AFP (AFP positivity) on the prognosis of resectable gastric cancers. Materials and Methods: 812 gastric cancer patients, who were investigated for serum AFP before their operations and who underwent gastric resections with D2 or more extended lymph node dissection, were enrolled in the study. The survival rates were calculated by using the Kaplan-Meier method and were compared by using the log-rank test. A multivariate analysis was performed using the Cox proportional hazards model. Results: Fifty patients ($6.2\%$) were AFP positive (10.1. 4322.6 ng/ml). The survival rate of the AFP positive group was significantly lower than that of the AFP negative group ( $46.6\%\;vs.\;67.0\%$; P=0.0002). The depth of tumor invasion, the degree of regional lymph node metastasis, distant metastases, the TNM stage, the gross type, differentiation, the extent of gastric resection, and the curability of the surgery also significantly influenced survival. Multivariate analysis revealed that the depth of tumor invasion, the degree of regional lymph node metastasis, the curability of the surgery, and AFP positivity were independent prognostic indicators. Conclusion: Preoperative serum AFP can be used as an independent prognostic factor of resectable gastric cancer.

• The Korean Journal of Nuclear Medicine Technology
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• v.22 no.2
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• pp.101-104
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• 2018

Purpose Alpha fetoprotein(AFP) is a fetal serum protein that increases in germ cell tumors derived from liver cancer or egg yolk. AFP test has been used for screening of liver cancer, determination of tumor stage, determination of therapeutic effect, and fetal congenital malformations. The purpose of this study was to compare the results of the four kits, identify the advantages and disadvantages of each kit, and select the appropriate kits for our laboratory. Materials and Methods Blood samples were obtained from 89 patients attending the Seoul national university hospital. Experiments were carried out in accordance with manufacturer's instructions of four companies(A, B, C, D). The precision, recovery, linearity, and sensitivity test were performed for each kit. Results In case of the precision within the measurement, the CV value of the C kit was less than 5% at the low, middle, and high concentrations. The A, B and D kit's the CV value was less than 5% at the concentrations except the low concentration. The recovery rates of the A, B, C, and D kits were $100{\pm}15%$, $100{\pm}30%$, $100{\pm}16%$ and $100{\pm}14%$, respectively. All kits showed good linearity. Sensitivity was measured as 0.5 IU/mL for A, 0.4 IU/mL for B, 0.98 IU/mL for C, and 0.3 IU/mL for D. Conclusion The CV values of the four kits were within 10%, and the correlation coefficients were close to 1 for $R^2=0.978$, $R^2=0.992$ and $R^2=0.8957$. As a result, they are clinically available. Therefore, each laboratory should select the appropriate kit for their experiment's environment.

• The Korean Journal of Zoology
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• v.38 no.3
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• pp.382-387
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• 1995

To check the possible application of our anti-AFP monocional antibodies (MAbs) as immunodiagnostic reagents for hepatocellular carcinoma, ELISA and immunohistochemical assay were performed on the sera and liver biopsy specimens from the patients of hepatocellular carcinoma and other non-malignant hepatic disease. By non-competitive ELISA using anti-AFP MAbs, the highest incidence of AFP value was found only in the sera of hepatocellular carcinoma patients, i.e., more than 54% of patients had serum AFP levels of more than 500 ng/mi. By immunoperoxidase and indirect immunofluorescence techniques, anti-AFP MAbs were found to react with cytoplasm of hepatoceliular carcinoma cells. However immunohistochemical reactIvity to AFP in hepatocellular carcinoma cells was lower than that in non-neoplastic liver cells adjacent to the hepatocellular carcinoma. From these results with the similar findings from other studies, we suggest that AFP antigen is appropriate in the diagnosis assay (ELISA) but is not by immunohistochemical detection.

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.168-174
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• 1997

Alphafetoprotein(AFP) is a glycoprotein synthesized by the fetus early in gestation by the yolk sac and later by the gastrointestinal tract and liver. The concentration of AFP is highest in fetal serum and amniotic fluid around 13th week, and 32nd week in maternal serum. Some conditions are associated with abnormal maternal serum AFP concentration. For examples, neural tube defects, omphalocele, renal anomalies are associated with elevated maternal serum AFP and fetal death, chromosomal trisomies are associated with low level of maternal serum AFP. So maternal serum AFP screening plays a significant role in assessing candidates for prenatal diagnosis and prenatal counselling in pregnant women. This study evaluates the normal ranges of AFP using enzyme immunoassay in normal pregnant women. We studied 500 normal pregnant women who visited the Department of Obstetrics & Gynecology, Yeungnam Medical Center, Yeungnam University during the period through January, 1993 to September, 1996. The group of the study were selected randomly at various gestational ages from 8 to 41 weeks. The results were summarized as follows: 1. The lowest level of AFP in our study group was 2.1ng/ml at 8 weeks of gestation. Thereafter serum alpha-fetoprotein concentrations rose rapidly to reach a peak value at 32nd week. 2. The mean levels of AFP in the primipara and multipara were $166.37{\pm}12.06ng/ml$, and $223.78{\pm}14.00ng/ml$, respectively, showing stastiscally significant difference between these two groups(p<0.01). 3. The mean levels of AFP between mothers who delivered male and female babies were $192.96{\pm}13.00ng/ml$, and $194.29{\pm}13.84ng/ml$, respectively, without statistically significant difference(p>0.05). 4. The normal ranges of maternal serum AFP according to each gestational week were evaluated.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3819-3823
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• 2013

Background: Hepatocellular carcinoma (HCC) is a major cause of cancer mortality worldwide. The outcome of HCC depends mainly on its early diagnosis. To date, the performance of traditional biomarkers is unsatisfactory. Talins were firstly identified as cytoplasmic protein partners of integrins but Talin-1 appears to play a crucial role in cancer formation and progression. Our study was conducted to assess the diagnostic value of serum Talin-1 (TLN1) compared to the most feasible traditional biomarker alpha-fetoprotein (AFP) for the diagnosis of HCC. Methods: TLN1 was detected using enzyme linked immunosorbent assay (ELISA) in serum samples from 120 Egyptian subjects including 40 with HCC, 40 with liver cirrhosis (LC) and 40 healthy controls (HC). Results: ROC curve analysis was used to create a predictive model for TLN1 relative to AFP in HCC diagnosis. Serum levels of TLN1 in hepatocellular carcinoma patients were significantly higher compared to the other groups (p<0.0001). The diagnostic accuracy of TLN1 was higher than that of AFP regarding sensitivity, specificity, positive predictive value and negative predictive value in diagnosis of HCC. Conclusions: The present study showed for the first time that Talin-1 (TLN1) is a potential diagnostic marker for HCC, with a higher sensitivity and specificity compared to the traditional biomarker AFP.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.6
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• pp.2985-2990
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• 2012

Background: Hepatocellular carcinoma (HCC), the main malignant tumor of the liver, is very common and highly lethal. The aim of this study was to determine its clinicopathologic characteristics and risk factors in Turkey. Materials and methods: In this study, patients who were diagnosed as suffering from HCC in the period between August 2004 and December 2011 were evaluated retrospectively. Results: A total of 98 patients were included, with a median age 61 (range: 16 to 82). Seventy nine (80.6%) were male 59 (60.2%) were infected with hepatitis B virus (HBV) and 15 (15.3%) with HCV, another 15 (15.3%) being alcohol abusers. Seventy two (73.5%) were at advanced stage and 54 (55.1%) had elevated serum alpha-fetoprotein (AFP). Surgery, chemoembolization, systemic chemotherapy and application of the tyrosine kinase inhibitor sorafenib were the major treatment options. Conclusions: According to our findings HCC is mostly diagnosed in advanced stage and age, being five times more common in males than females. Main risk factors of HCC are HBV infection, HCV infection and alcohol abuse. Elevation in AFP may facilitate early diagnosis of HCC in high risk groups.

• Tuberculosis and Respiratory Diseases
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• v.72 no.1
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• pp.72-76
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• 2012

We observed a very rare case of primary lung cancer producing alpha-fetoprotein (AFP). A 70-year-old male with a history of smoking 50 packs per year was diagnosed with large cell carcinoma of the lung. The clinical stage was T2bN3M0 (IIIB), and serum AFP was 23,247 ng/mL. There was no evidence of metastasis to the liver, scrotum or other organs. While undergoing chemotherapy for 1 year, as the cancer progressed the AFP value steadily increased. The patient died of respiratory failure due to pneumonia 12 months after being diagnosed with lung cancer.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1539-1544
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• 2014

Purpose: Alpha-fetoprotein (AFP), Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and Golgi protein 73 (GP73) levels have been widely used as tumor markers for the diagnosis of hepatocellular carcinoma (HCC). The aim of this study was to investigate whether these tumor markers could be used to monitor short-term treatment response and recurrence of HCC in patients undergoing radiofrequency ablation (RFA). Methods: Between July 2012 and July 2013, 53 consecutive patients with newly diagnosed HCC were prospectively enrolled in this study. Among these, 32 patients underwent RFA, after which they were followed up prospectively at the First Hospital of Jilin University in China. Results: AFP, AFP-L3, and GP-73 values pre-RFA were not associated with tumor size, whereas AFP and GP-73 levels tended to be associated with tumor number, the presence of vascular invasion, deterioration of liver function, advanced-stage disease, and a poor performance status. GP-73 levels were dramatically elevated in the patients with hepatitis C-associated HCC. Neither pre-RFA nor 1-month post-RFA tumor marker values were associated with short-term outcome. The short-term recurrence rate of AFP-positive patients measured 1 month post-RFA was obviously higher than that of AFP-negative patients. Conclusions: AFP and GP-73 values were associated with clinical variables representing tumor growth and invasiveness, and the AFP value measured 1 month post-RFA was a strong predictor of short-term recurrence in patients with HCC.

• The Korean Journal of Nuclear Medicine Technology
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• v.13 no.3
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• pp.189-192
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• 2009

Purpose: Autopipetting system is an efficient automated equipment pipetting patient samples and reagents for rapid and accurate test. However, it can cause carryover between high concentration sample and low concentration sample. We evaluated carryover contamination of TECAN freedom Evo 100 autopipetting system. Materials and Method: We studied carryover contamination of $\alpha$-fetoprotein (AFP) and carcinoembryonic antigen (CEA) test on TECAN freedom Evo 100 autopipetting system. Very low concentration control samples were pipetted for comparison to the contaminated very low concentration samples. Then, The contaminated very low concentration samples were pipetted following the high concentration samples were pipetted alternately. The difference of low concentration samples represents carryover. The target value to decide carryover was 1ppm (parts per million). Results: For AFP, the mean values of the uncontaminated control samples and the contaminated samples were less than 0.6 IU/mL (the l imit of detection (LoD)). Carryover did not occur even though the high concentration sample which value was 650000 IU/mL. For CEA, the values of the low concentration control samples and the contaminated samples were less than 0.2 ng/mL (LoD). Carryover did not occur even though the high concentration sample which value was 65,000 ng/mL. Conclusions: Sample carryover was not found on TECAN freedom Evo 100 autopipetting system for AFP, CEA. However, carryover is a potential problem with automated instruments and robotic pipetting systems. Therefore, Clinical laboratories must periodically verify carryover contamination for the accurate and confidential test results.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.2
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• pp.719-722
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• 2015

Objective: To evaluate the values of 4 tumor markers in serum and ascites and their ascites/serum ratios in the identification and diagnosis of benign and malignant ascites. Materials and Methods: A total of 76 patients were selected as subjects and divided into malignant ascites group (45 cases) and benign ascites group (31 cases). Samples of ascites and serum of all hospitalized patients were collected before treatment. The levels of carcinoembryonic antigen (CEA), alpha fetoprotein (AFP), cancer antigen 125 (CA125) and carbohydrate antigen 19-9 (CA19-9) were detected by chemiluminescence (CLIA). Results: CEA, AFP and CA19-9 in both serum and ascites as well as CA125 in ascites were evidently higher in the malignant ascites group than in the benign ascites group (P<0.01). Malignant ascites was associated with elevated ascites/serum ratios for AFP and CA125 (P<0.01). The areas under receiver operating characteristic (AUROCs) of CEA and CA125 in ascites and the ratios of ascites/serum of AFP, CEA, CA125 and CA19-9 were all >0.7, suggesting certain values, while those of ascites CA19-9 and serum CEA were 0.697 and 0.629 respectively, indicating low accuracy in the identification and diagnosis of benign and malignant ascites. However, the AUROCs of the remaining indexes were <0.5, with no value for identification and diagnosis. Compared with single index, the sensitivity of combined detection increased significantly (P<0.05), in which the combined detection of CEA, CA19-9 and CA125 in ascites as well as the ratio of ascites/serum of CEA, CA19-9, CA125 and AFP had the highest sensitivity (98.4%) but with relevantly low specificity. Both sensitivity and specificity of combined detection should be comprehensively considered so as to choose the most appropriate index. Conclusions: Compared with single index, combined detection of tumor markers in serum and ascites can significantly improve the diagnostic sensitivity and specificity.