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Disease Markers
Volume 30, Issue 6, Pages 307-315

Clinical Utility of Alpha Fetoprotein and HCCR-1, Alone or in Combination, in Patients with Chronic Hepatitis, Liver Cirrhosis and Hepatocellular Carcinoma

Peng Jirun,1 Guoxin Zhang,2 Hyun Kee Kim,3 Seon-Ah Ha,3 Jin Zhongtian,1 Qiao Shishi,1 Cui Zhuqingqing,1 Gong Lei,1 Jinah Yoo,3 Sanghee Kim,3 Yong Gyu Park,5 Jing Wang,2 Yang Yang,2 Zekuan Xu,2 Zuhu Huang,2 Yun Kyung Lee,3 Eun Young Song,6 and Jin Woo Kim3,4

1Department of Surgery, Peking University People’s Hospital, Beijing, China
2Department of Gastroenterology, The first affiliated hospital of Nanjing Medical University, Nanjing, China
3Molecular Genetic Laboratory, College of Medicine, The Catholic University of Korea, Seoul 137-040, Republic of Korea
4Departments of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul 137-040, Republic of Korea
5Departments of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul 137-040, Republic of Korea
6The Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea

Received 28 June 2011; Accepted 28 June 2011

Copyright © 2011 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Serum alpha fetoprotein (AFP) is the most widely used tumor marker in detecting patients with hepatocellular carcinoma (HCC). However, it has been indicated that HCCR-1 (human cervical cancer oncogene 1) might be supplementary to AFP in the detection. We conducted a prospective study in 120 normal and 524 liver disease patients to evaluate the significance of simultaneous measurement of 2 tumor markers (AFP and HCCR-1) in the diagnosis of HCC through the cohort study in Korea and China. We also performed immunohistochemical studies using 25 normal subjects (N), 32 liver cirrhosis (LC) and 116 HCC tissues. The sensitivities of AFP (20 ng/mL) and HCCR-1 (10 ng/mL) in HCC were 55.8% (164/294) and 44.2% (130/294), respectively. When AFP was combined with HCCR-1, sensitivities increased to 4.2% (N), 12.7% (chronic hepatitis; CH), 50.0% (LC), and 77.2% (HCC), respectively. Although there was no significant difference in the diagnostic rate for HCC between AFP and HCCR-1, many cases for AFP-negative HCC were positive for HCCR-1 and vice versa. Moreover, the combined use of AFP and HCCR-1 improved the diagnostic rate to 70.8% in small HCC (< 2 cm) and 81.6% in large HCC (≥ 2 cm), respectively. AFP and HCCR-1 are independent markers. Our result suggests that the HCCR-1 could be an useful biomarker for HCC while the diagnostic rate could be significantly improved in the combined use of HCCR-1 and AFP.