caa a22 4500 445887761 CHVBK 20180317145604.0 cr unu---uuuuu 170323e20110101xx s 000 0 eng 10.1007/s00535-010-0293-6 doi (NATIONALLICENCE)springer-10.1007/s00535-010-0293-6 Alpha-fetoprotein above normal levels as a risk factor for the development of hepatocellular carcinoma in patients infected with hepatitis C virus [Elektronische Daten] [Masakuni Tateyama, Hiroshi Yatsuhashi, Naota Taura, Yasuhide Motoyoshi, Shinya Nagaoka, Kenji Yanagi, Seigo Abiru, Koji Yano, Atsumasa Komori, Kiyoshi Migita, Minoru Nakamura, Hiroyasu Nagahama, Yutaka Sasaki, Yuzo Miyakawa, Hiromi Ishibashi] Background: Noninvasive risk factors are required for predicting the development of hepatocellular carcinoma (HCC) not only in patients with cirrhosis but also in those with chronic hepatitis who are infected with hepatitis C virus (HCV). Methods: A total of 707 patients with chronic HCV infection without other risks were evaluated for the predictive value of noninvasive risk factors for HCC, including age, sex, viral load, genotype, fibrosis stage, aspartate and alanine aminotransferase levels, bilirubin, albumin, platelet count, and alpha-fetoprotein (AFP) at entry to the study, as well as interferon (IFN) therapy they received. Results: The ten-year cumulative incidence rates of HCC for patients with fibrosis stages F0/F1, F2, F3, and F4 were 2.5, 12.8, 19.3, and 55.9%, respectively. Multivariate analysis identified age ≥57years [hazard ratio (HR) 2.026, P=0.004], fibrosis stage F4 (HR 3.957, P<0.001), and AFP 6-20ng/mL (HR 1.942, P=0.030) and ≥20ng/mL (HR 3.884, P<0.001), as well as the response to IFN [relative risk (RR) 0.099, P<0.001], as independent risk factors for the development of HCC. The ten-year cumulative incidence rates of HCC in the patients with AFP levels of <6, 6-20, and ≥20ng/mL at entry were 6.0, 24.6, and 47.3%, respectively. Conclusions: Not only high (>20ng/mL), but also even slightly elevated (6-20ng/mL) AFP levels, could serve as a risk factor for HCC to complement the fibrosis stage. In contrast, AFP levels <6ng/mL indicate a low risk of HCC development in patients infected with HCV, irrespective of the fibrosis stage. Springer, 2010 Alpha-fetoprotein nationallicence Hepatitis C virus nationallicence Hepatocellular carcinoma nationallicence Tateyama Masakuni Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut Yatsuhashi Hiroshi Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut Taura Naota Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut Motoyoshi Yasuhide Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut Nagaoka Shinya Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut Yanagi Kenji Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut Abiru Seigo Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut Yano Koji Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut Komori Atsumasa Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut Migita Kiyoshi Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut Nakamura Minoru Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut Nagahama Hiroyasu Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, 860-8556, Kumamoto, Japan aut Sasaki Yutaka Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, 860-8556, Kumamoto, Japan aut Miyakawa Yuzo Miyakawa Memorial Research Foundation, 107-0062, Tokyo, Japan aut Ishibashi Hiromi Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut Journal of Gastroenterology Springer Japan 46/1(2011-01-01), 92-100 0944-1174 46:1<92 2011 46 535 https://doi.org/10.1007/s00535-010-0293-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00535-010-0293-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Tateyama Masakuni Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut NATIONALLICENCE 700 1- Yatsuhashi Hiroshi Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut NATIONALLICENCE 700 1- Taura Naota Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut NATIONALLICENCE 700 1- Motoyoshi Yasuhide Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut NATIONALLICENCE 700 1- Nagaoka Shinya Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut NATIONALLICENCE 700 1- Yanagi Kenji Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut NATIONALLICENCE 700 1- Abiru Seigo Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut NATIONALLICENCE 700 1- Yano Koji Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut NATIONALLICENCE 700 1- Komori Atsumasa Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut NATIONALLICENCE 700 1- Migita Kiyoshi Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut NATIONALLICENCE 700 1- Nakamura Minoru Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut NATIONALLICENCE 700 1- Nagahama Hiroyasu Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, 860-8556, Kumamoto, Japan aut NATIONALLICENCE 700 1- Sasaki Yutaka Department of Gastroenterology and Hepatology, Graduate School of Medical Sciences, Kumamoto University, 860-8556, Kumamoto, Japan aut NATIONALLICENCE 700 1- Miyakawa Yuzo Miyakawa Memorial Research Foundation, 107-0062, Tokyo, Japan aut NATIONALLICENCE 700 1- Ishibashi Hiromi Clinical Research Center, National Nagasaki Medical Center, 856-8562, Nagasaki, Japan aut NATIONALLICENCE 773 0- Journal of Gastroenterology Springer Japan 46/1(2011-01-01), 92-100 0944-1174 46:1<92 2011 46 535 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer