AFP-negative HBV-related Hepatocellular Carcinoma:A Case Report And Literature Review

Objective: Hepatocellular carcinoma(HCC)is a malignant tumor with high morbidity and mortality,which brings a serious burden to society.It is the fifth leading cancer and the second most common cause of cancer-related death in the world.According to the 2018 cancer statistics,the mortality rate of HCC has increased gradually in the past decade,but the overall cure rate has not increased significantly.The currently identified high risk factors for HCC include hepatophilic virus infection,long-term alcohol abuse,aflatoxin exposure,parasitic infection and heredity.Chronic persistent infection with hepatitis B virus(HBV)is the most common risk factor for HCC in China.Chinese latest guideline recommend monitoring alpha-fetoprotein(AFP)and liver ultrasound every 6 months for high-risk populations.However,a considerable number of HCC patients did not find elevated AFP even in late stage.Therefore,relying on AFP detection may miss the best period of diagnosis and treatment of HCC,resulting in poor prognosis and shortened survival.In order to find and diagnose in the early stage,which guide the formulation of treatment plan and improve the 5-year survival rate.This article elaborates the clinical characteristics and diagnostic methods of AFP-negative hepatocellular carcinoma.Methods: Select the patient’s clinical datas who had AFP-negative HBV-related HCC,the patient hospitalized in Infection Disease Deparment of the Third Hospital of Hebei Medical University on 2018.At the same time,we consult relevant literatures at home and abroad and summarize the pathogenesis,clinical characteristics,diagnostic and therapeutic method,which provide assistance for diagnosis,treatment and prognostic evaluation of AFP-negative HBV-related HCC.Result: The patient infects hepatitis B virus and AFP is always negative so far.Space-occupying lesions in liver is firstly detected by imaging examination,which had a high possibility of malignancy.Surgical resection was performed and the postoperative pathology confirmed hepatocellular carcinoma.Conclusion: AFP-negative HBV-related hepatocellular carcinoma is prone to missed diagnosis in clinical work,which should be paid attention to by clinicians.