Is There Still a Role for Alpha-Fetoprotein in Hepatocellular Carcinoma Surveillance?

Use of serum alpha-fetoprotein (AFP) for hepatocellular carcinoma (HCC) surveillance is controversial due to reports of high false-positive and false-negative rates.

To evaluate the accuracy of AFP, abdominal ultrasound, and both combined in diagnosing HCC in patients with cirrhosis, researchers conducted a retrospective analysis of patients aged ≥20 years who underwent both AFP and ultrasound between 2002 and 2010 at a single tertiary care center in Taiwan. Patients were followed until June 2013.

During a median follow-up of 4.75 years (8563 person-years), 363 of 1597 patients (22.7%) developed HCC. Using the traditional cutoff level of 20 ng/mL, the sensitivity and specificity of AFP were 52.9% and 93.3%, respectively. Ultrasound alone had …