한국인 간세포암종의 혈청 alpha-fetoprotein 농도에 따른 임상적 특징

Background/Aims: As a tumor marker, alpha-fetoprotein is widely used. Diagnositic cut-off value is known as 400 ng/mL in sera. This study is aimed to determine the clinical features of hepatocellular carcinoma (HCC) with reference to serum AFP levels in Korean patients. Methods: From May 1990 to March 1998, 367 patients diagnosed as HCC, hospitalized and followed-up at Hanyang University Hospital, have been retrospectively analyzed with special reference on serum AFP level at time of diagnosis. The differences in clinical, hematological, and radiological features of HCC, as well as the survival rate in the two groups have been compared. Group 1 (N=182) was defined as an AFP level lower than 400 ng/mL, group 2 (N=185) was defined as an AFP level greater than 400 ng/mL. Comparisons were made by student's t test or chi-square test. Survival rate was calculated from the time of diagnosis by Kaplan-Meier method. Survival curves were also compared using log-rank test. P values less than 0.05 were considered significant. Results: The patients with serum AFP levels above 400 ng/mL showed (1) a lower mean age; (2) a higher level of AST; (3) a higher level of AST/ALT ratio; (4) a high incidence of liver cirrhosis; (5) a high incidence of portal vein thrombosis; (6) a high incidence of positive HBsAg; (7) a low incidence of anti-HCV; (8) a low incidence of small HCC but high incidence of large HCC; (9) a high incidence of more advanced TNM stage; (10) a low incidence of single nodular type and high incidence of diffuse type. Conclusions: Depending on the value of AFP, HCC has some clinical features. In hepatocellular carcinoma, high levels of AFP represent young age, HBV infection more than HCV infection and advanced disease state. (Korean J Hepatol 1999;5:322－331)