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Clinical Chemistry 49: 1209-1211, 2003; 10.1373/49.7.1209
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(Clinical Chemistry. 2003;49:1209-1211.)
© 2003 American Association for Clinical Chemistry, Inc.

Technical Briefs

Reference Change Value for {alpha}-Fetoprotein and Its Application in Early Detection of Hepatocellular Carcinoma in Patients with Hepatic Disease

Jaume Trapé1,a, Josep M. Botargues2, Francesc Porta2, Carmen Ricós4, Josep M. Badal3, Ramon Salinas1, Maria Sala1 and Angels Roca1

1 Laboratori d’Analisis Clíniques,
2 Secció de Gastroenterologia, and
3 Servei d’Anatomia Patologica, Hospital Sant Joan de Déu, Althaia Xarxa Assistencial de Manresa, Dr. Joan Soler, s/n 08243 Manresa, Barcelona, Spain

4 Laboratoris Clínics Hospital Vall d’Hebron, 08035. Barcelona, Spain

aauthor for correspondence: fax 34-93-8743859, e-mail hgmlaboratorio@aehh.org

The first 300 words of the full text of this article appear below.

Hepatocellular carcinoma (HCC) is one of the most frequent types of cancer worldwide, with an incidence of 150 cases per 100 000 inhabitants per year in Asia and Africa and ~5 cases per 100 000 per year in Europe, North America, and Australia (1). HCC can occur in healthy livers, but it is generally associated with hepatic disease. Cirrhosis is the most important risk factor for its development (2).

Many studies have been dedicated to the early detection of HCC in patients with chronic liver disease (CLD), based on semiannual or annual measurement of serum {alpha}-fetoprotein (AFP) and ultrasound study of the liver. The interpretation of AFP results usually involves comparison with a fixed cutoff ranging from 20 to 500 µg/L, with sensitivities ranging from 33% to 64% (3)(4)(5). Another approach would be to assess changes in consecutive results from the same patient.

To establish a criterion for dynamic assessment of a specific biological constituent, the first step is to define when a difference between two consecutive results indicates a change in a patient’s health status. The most widely accepted approach for this purpose is the so-called reference change value (RCV), a concept described by Harris and Brown (6). Using serial analytic results from the same individual for a specific constituent, it is possible to calculate the RCV that defines how large a difference between two consecutive determinations is statistically significant (P <0.05). The RCV encompasses both biological and analytical variation.

The RCV has been determined for various constituents in healthy persons and in some pathologies (7)(8)(9)(10)(11)(12)(13). In diseases that can modify the homeostatic set point and the degree of fluctuation of a . . . [Full Text of this Article]




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eLetters:

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Alpha fetoprotein-linked immunoglobulin complex in blood
Toshio Okazaki, et al.
Clinical Chemistry Online, 5 Oct 2004 [Full text]

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