{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,5]],"date-time":"2026-10-05T11:56:48Z","timestamp":1791201408923,"version":"4.2.0"},"reference-count":24,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,5]],"date-time":"2026-06-05T00:00:00Z","timestamp":1780617600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Hepatology Research"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background and Aim<\/jats:title>\n                    <jats:p>Alpha\u2010fetoprotein (AFP) is widely used in hepatocellular carcinoma (HCC) surveillance, but its performance may vary with etiology and tumor stage. We assessed etiology\u2010specific AFP and des\u2010gamma\u2010carboxyprothrombin (DCP) positivity at HCC diagnosis, focusing on early\u2010stage disease.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We retrospectively enrolled consecutive adults with newly diagnosed, treatment\u2010na\u00efve HCC at two tertiary centers in Japan (2007\u20132023). AFP (cutoff \u2265 10\u00a0ng\/mL) and DCP (\u2265 40 mAU\/mL) at diagnosis were analyzed overall and by etiology (Hepatitis B virus (HBV), Hepatitis C virus (HCV), sustained virological response [SVR], and non\u2010B\/non\u2010C [NBNC]). Early stage was defined as Barcelona Clinic Liver Cancer (BCLC) 0\/A and Union for International Cancer Control tumor\u2013node\u2013metastasis (UICC) T1a.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Among 1396 patients, 760 (54.4%) had BCLC 0\/A and 278 (19.9%) had T1a tumors. AFP positivity differed by etiology in BCLC 0\/A disease (HBV 50.0%, HCV 64.6%, SVR\u2010related 39.0%, NBNC 39.7%;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), and in T1a tumors (48.1%, 60.3%, 39.0%, and 34.5%, respectively;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.002). DCP (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a01364) positivity in BCLC 0\/A showed less variability (40.6%, 47.8%, 40.8%, and 58.4%, respectively;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.005). Either\u2010marker positivity in BCLC 0\/A increased (64.1%, 80.0%, 59.2%, and 70.6%, respectively); the incremental yield from DCP alone among AFP\u2010negative cases was 21.1% in SVR\u2010related and 30.5% in NBNC early\u2010stage HCC.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AFP positivity at diagnosis was substantially lower in early\u2010stage SVR\u2010related and NBNC HCC than in HCV\u2010related HCC. Adding DCP provides complementary detection, supporting an etiology\u2010aware dual\u2010marker strategy at diagnosis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/hepr.70215","type":"journal-article","created":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T06:05:54Z","timestamp":1780725954000},"page":"1475-1483","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Low Alpha\u2010Fetoprotein in Non\u2010Viral Early\u2010Stage Hepatocellular Carcinoma: Complementary Des\u2010Gamma\u2010Carboxyprothrombin"],"prefix":"10.1111","volume":"56","author":[{"given":"Yuji","family":"Ikeda","sequence":"first","affiliation":[{"name":"Department of Gastroenterology and Hepatology Juntendo University Shizuoka Hospital  Shizuoka 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