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. 2012 Mar 19;32(4):265–271. doi: 10.3233/DMA-2011-0878

Combined Analysis of AFP and HCCR-1 as an Useful Serological Marker for Small Hepatocellular Carcinoma: A Prospective Cohort Study

Guoxin Zhang 1, Seon-Ah Ha 2, Hyun K Kim 2, Jinah Yoo 2, Sanghee Kim 2, Youn S Lee 3, Soo Y Hur 4, Yong W Kim 4, Tae E Kim 4, Yong G Park 5, Jing Wang 1, Yang Yang 1, Zekuan Xu 1, Eun Y Song 6, Zuhu Huang 1, Peng Jirun 7, Jin Zhongtian 7, Qiao Shishi 7, Cui Zhuqingqing 7, Gong Lei 7, Jin W Kim 2,4,*
PMCID: PMC3826799  PMID: 22430193

Abstract

Hepatocellular carcinoma (HCC) is one of the most frequent malignant tumors in the world. The only serological marker widely used for the diagnosis of HCC is alpha-fetoprotein (AFP). Despite that AFP is widely used for the diagnosis of HCC, it has a limit as a serological marker due to its low sensitivity and specificity. The human cervical cancer proto-oncogene 1 (HCCR-1) was previously reported as a new biomarker for HCC. To further evaluate the HCCR-1 as a biomarker for HCC, we conducted the prospective cohort study. We evaluated the significance of simultaneous measurement of 2 tumor markers in the diagnosis of HCC in China, Japan and Korea. Two markers for HCC, AFP and HCCR-1, were measured in the sera obtained from 1,338 patients at the time of initial diagnosis of HCC. Of the 1338 HCC patients, 616 (46%) and 686 (51.3%) were sero-positive for AFP and HCCR-1, respectively. The positive rate for HCC was increased up to 74.1% in combined use of AFP and HCCR-1. Many cases (54%) for AFP-negative HCC were positive for HCCR-1 and vice versa. More importantly, the diagnostic rate for small HCC (< 2 cm) was significantly improved in the combined analysis of AFP and HCCR-1 to 56.9% although it was only 40.1% and 23.4% in the single analysis of HCCR-1 and AFP, respectively. Our result suggests that the HCCR-1 could be an useful biomarker for HCC while the diagnostic rate could be significantly improved in the combined use of HCCR-1 and AFP.

Keywords: Hepatocellular carcinoma, biomarker, AFP, HCCR-1

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