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Role of alpha-fetoprotein in complex diagnostics of progressing course of chronic hepatitis B and C

Abstract

Aim of investigation. To determine the role of alpha-fetoprotein (AFP) in complex diagnostics of progressing course of chronic hepatitises B and C.
Material and methods. Overall 69 patients with chronic viral hepatitis were investigated: 39 with chronic hepatitis B (CHB) and 30 — with chronic hepatitis C (CHC) without signs of cirrhotic transformation and liver cancer. The diagnosis was verified by clinical, laboratory and morphological – with assessment of histological activity index (HAI) and histological sclerosis index (HSI), instrumental (transabdominal ultrasound, Doppler ultrasonography of portal blood flow), virologic studies. AFP level was determined by chemiluminescent solid-phase analysis by «Immulite AFP» test-systems (USA).
Results. The mean level of AFP CHB patients 2,6 times, and in CHC patients – 5,4 times exceeded score in the control group. The level of AFP closely correlated with necroinflammatory parameters, sclerosis and portal blood flow, especially in hepatitis of high activity (HA). At HA CHB relation of AFP to histological activity (0,93; p<0,01), sclerosis index (0,69; p <0,01), hepatic vascular index (–0,93; p<0,01) was maximal. At HA CHC close correlations were revealed between AFP and ALT (0,56; p<0,05), histological activity (0,73; p<0,01), HSI (0,65; p<0,05) and portal hypertension index (0,45; p<0,01)
Conclusions. AFP can be used for diagnostics necroinflammation progression, sclerosis and impairment of perfusion of the liver in patients with chronic viral hepatites B and C.

About the Authors

I. A. Belavina
Petrozavodsk state university
Russian Federation


O. P. Dudanova
Petrozavodsk state university
Russian Federation


References

1. Ивашкин В.Т., Морозова М.А., Маевская М.В. и др. Факторы риска развития гепатоцеллюлярной карциномы // Рос. журн. гастроэнтерол. гепатол. колопроктол. – 2009. – Т. 19, № 1. – С. 4–15.

2. Chen C.H., Lin S.T., Kuo C.L., Nien C.K. Clinical significance of elevated alpha-fetoprotein (AFP) in chronic hepatitis C without hepatocellular carcinoma // Hepatogastroenterology. – 2008. – Vol. 55, N 85. – P. 1423–1427.

3. Chen D.S., Sung J.L. Relationship of hepatitis B surface antigen to serum alfa-fetoprotein in nonmalignant disease of the liver // Cancer. – 1979. – Vol. 44. – P. 984–992.

4. Chu C.-W., Hwang S.-J., Luo J.-C. et al. Clinical, virological and pathologic significance of elevated serum alpha-fetoprotein levels in patients with chronic hepatitis C // J. Clin. Gastroenterol. – 2001. – Vol. 32. – P. 240–244.

5. Di Bisceglie A.M., Sterling R.K., Chung R.T. et al. Serum alpha-fetoprotein levels in patients with advanced hepatitis C. Results from the HALT-C trial // J. Hepatol. – 2005. – Vol. 43. – P. 434–441.

6. Fung J., Lai C.L., Fong D.Y. et al. Correlation of liver biochemistry with liver stiffness in chronic hepatitis B and development of a predictive model for liver fibrosis // Liver Int. – 2008. – Vol. 28, N 10. – P. 1408–1416.

7. Han Y., Tang Q., Zhu W. et al. Clinical, biochemical, immunological and virological profiles of, and differential diagnosis between patients with acute hepatitis B and chronic hepatitis B with acute flare // J. Gastroenterol. Hepatol. – 2008. – Vol. 23. – P. 1728–1733.

8. Hu K.-Q., Kyulo N. L., Lim N. et al. Clinical significance of elevated alpha-fetoprotein (AFP) in patients with chronic hepatitis C, but not hepatocellular carcinoma // Am. J. Gastroenterol. – 2004. – Vol. 99, N 5. – P. 860– 865.

9. Lee I.C., Huang Y.H., Chan C.C. et al. Correlation between clinical indication for treatment and liver histology in HBeAg-negative chronic hepatitis B: a novel role of alpha-fetoprotein // Liver Int. – 2010. – Vol. 30, N 8. – Р. 1161–1168.

10. Omran M.M., Farid K., Emran T.M., Attalah A.A. Fibro-α score as a simple and useful non-invasive test for predicting significant liver fibrosis in chronic hepatitis C patients // Arab. J. Gastroenterol. – 2011. – Vol. 12, N 2. – P. 74–79.

11. Peng J., Wang C., Zhang Q. et al. Association of HBeAg positivity and alpha-fetoprotein level with the prognosis of chronic severe hepatitis B // Nan Fang Yi Ke Da Xue Xue Bao. – 2008. – Vol. 28, N 10. – P. 1768–1770.

12. Tai W.C., Hu T.H., Wang J.H. et al. Clinical implications of alpha-fetoprotein in chronic hepatitis C // J. Formos Med. Assoc. – 2009. – Vol. 108, N 3. – P. 210– 218.

13. Wilfredo Canchis P., Gonzalez S.A., Isabel Fiel. Hepatocyte proliferation in chronic hepatitis C: correlation with degree of liver disease and serum alpha-fetoprotein // Liver Int. – 2004. – Vol. 24, N 3. – P. 198–203.


Review

For citations:


Belavina I.A., Dudanova O.P. Role of alpha-fetoprotein in complex diagnostics of progressing course of chronic hepatitis B and C. Russian Journal of Gastroenterology, Hepatology, Coloproctology. 2012;22(3):57-62. (In Russ.)

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ISSN 1382-4376 (Print)
ISSN 2658-6673 (Online)