Clinical significance of α- fetoprotein in initial diagnosis of primary hepatic cancer

Objective To investigate the value ofα- fetoprotein ( AFP) in the initial diagnosis of primary hepatic cancer ( PHC) . Methods A retrospective analysis was performed on the initial AFP measurement results and imaging findings of 177 patients who had relatively complete clinical data and had a confirmed diagnosis of PHC; 98 patients with chronic hepatitis B ( CHB) and 82 patients with post- hepatitis B cirrhosis ( PHBC) , who were admitted to our department in 2011, were enrolled as controls. The obtained data were subjected to statistical analysis using SAS software; the enumeration data were subjected to chi- square test. Results In the initial examination for the 177PHC patients, 93 ( 52. 54%) had a serum AFP level not lower than 400 ng / ml, 38 ( 21. 47%) had a serum AFP level between 20 ng / ml and 400 ng / ml, and 46 ( 25. 99%) had a normal serum AFP level; the abnormal rate of AFP level was 74. 01%, which was significantly higher than those of CHB group ( χ2= 106. 07, P < 0. 001) and PHBC group ( χ2= 67. 82, P < 0. 001) . Among the 177 PHC patients, 63 ( 35. 59%) had a serum AFP level lower than 400 ng/ml in the course of disease. The serum AFP level was significantly lower in patients with a tumor diameter not larger than 3 cm than in those with a tumor diameter larger than 5 cm ( χ2= 8. 62, P < 0. 005) . In the initial examination, serum AFP level yielded a significantly lower correct diagnosis rate than B- mode ultrasound ( χ2= 30. 39, P < 0. 000) and computed tomography ( χ2= 84. 83, P < 0. 000) . Conclusion The abnormal rate of AFP level is higher in PHC patients than in those with CHB and PHBC during initial examination, and the higher the serum AFP level, the higher its diagnostic value. There is a certain relationship between serum AFP level and tumor size. Attention should also be paid to those with negative results of AFP detection. Dynamic monitoring of AFP level combined with imaging examination is helpful for early and correct diagnosis.