Hepatocellular Carcinoma (HCC) Markers




Hepatocellular carcinoma (HCC, also called hepatoma) is a primary malignancy (cancer) of the liver. Most cases of HCC are secondary to either hepatitis infection (usually hepatitis B or C) or cirrhosis (alcoholism being the most common cause of hepatic cirrhosis). In countries where hepatitis is not endemic, most malignancy cancers in the liver are not primary HCC but metastasis (spread) of cancer from elsewhere in the body, e.g. the colon. Treatment options of HCC and prognosis are dependent on many factors but especially on tumor size and staging.




7S collagen

  • Measuring the serum 7S collagen concentration is useful to estimate the risk of recurrence after resection of hepatocellular carcinoma (HCC). PMID: 12759499

AFP (alpha fetoprotein)

  • a hepatocellular tumor marker. PMID: 12193284

  • AFP-L3 is a new generation of tumor marker for HCC and yields useful information on HCC for clinical decision making. PMID: 11694234

  • The simultaneous determinations of serum AFP and plasma nitrite/nitrate concentrations gave significant improvement in detection of HCC in CLD patients compared with that of serum AFP alone. PMID: 10807981

  • Serum alpha-fetoprotein (AFP) is frequently used for the diagnosis of hepatocellular carcinoma (HCC). PMID: 17132920

  • a potential prognostic marker in hepatocellular carcinoma. PMID: 16124056

  • the monitoring of serum AFP level in those high-risk patients can be valuable for screening and monitoring of hepatocellular carcinoma. PMID: 8703246

  • widely used as a marker of hepatocellular carcinoma (HCC) for assisting diagnosis and also for screening purposes, even though its sensitivity has been decreased slightly as a result of the earlier detection of HCC by ultrasonography. PMID: 1379253


  • potentially a clinically useful marker for differentiation of increased AFP in hepatocellular carcinoma and other malignancies from that in precancerous chronic hepatitis or cirrhosis. PMID: 9681296


  • pretreatment status of AFP-L3 could be considered a useful marker for predicting clinical outcome in patients with HCC who underwent TACE. PMID: 12394228

  • a useful indicator of distant metastasis and a poor prognosis for HCC. PMID: 10523686

  • Measurement of AFP-L3% after treatment may be useful for understanding prognosis and recurrence of HCC. PMID: 10520864

AFU (alpha-L-fucosidase)

  • a useful marker, in conjunction with AFP and ultrasonography, for detecting HCC, particularly in patients with underlying viral hepatitis and cirrhosis. PMID: 10695798


  • appears to be a sensitive diagnostic marker of both advanced and small hepatocellular carcinoma-complicating liver cirrhosis. PMID: 12603529

alpha-L-fucosidase (ALF)

  • a useful marker for detecting HCC, in conjunction with alpha-fetoprotein and ultrasonography. PMID: 1381268

  • ALF level may be of value in the early detection of primary hepatocellular carcinoma (PHC) as well as in the follow-up of patients treated for PHC. PMID: 1712699

  • alpha-L-fucosidase is less useful than alpha-fetoprotein as a single marker of hepatocellular carcinoma in southern African blacks. However, the two markers can profitably be used together. PMID: 2467686


  • overexpression of alpha-prothymosin in HCC patients, correlated with c-myc, is possibly involved in the tumorigenic process and may be a novel molecular marker for human HCC. PMID: 9365169

CA 125

  • In situations of low HCC prevalence, CA 125 could serve as a first-line screening test followed by confirmation of positives by AFP. PMID: 8915714

  • a highly sensitive marker for hepatocellular carcinoma, but lacks specificity. PMID: 2172170


  • more sensitive in differentiating between HCC and non-HCC than CD10(can), p-CEA(can), HepPar1, and AFP. PMID: 16189153


  • gene expression appears to be a common event in HCC and may serve as an early but not prognostic biomarker for malignant transformation of hepatocytes. PMID: 7553654


  • comparison of C/EBP alpha and C/EBP beta expression between tumors and non-tumorous regions could be a prognostic marker for patients with hepatocellular carcinoma. PMID: 12680236


  • an excellent candidate as a new clinical marker of HCC. PMID: 12642876

DCP (des-gamma-carboxy prothrombin)

  • Simultaneous determination of DCP and AFP should be applied in mass survey programs for detecting primary hepatocellular carcinoma (PHC), especially in countries with a high prevalence of hepatitis B virus infection. PMID: 2467347

Glypican-3 (GPC3)

  • overexpressed specifically in human hepatocellular carcinoma, is a novel tumor marker. PMID: 12788060

  • one of the oncofetal proteins now attracting attention for their promise both as markers of hepatocellular carcinoma in routine histological examination and as targets in monoclonal antibody-based hepatocellular carcinoma therapy. PMID: 15920546

  • a novel serum and histochemical marker for hepatocellular carcinoma. PMID: 12851874


  • a resident Golgi glycoprotein, is a novel serum marker for hepatocellular carcinoma. PMID: 16137783


  • highly and specifically induced during early hepatocarcinogenesis as well as in hepatocellular carcinoma cells. PMID: 15863507


  • the persistence of HBxAg is important to the pathogenesis of early HCC and that HBxAg expression in the liver during chronic HBV infection may be an important prognostic marker for the development of HCC. PMID: 8406983

HD (Hanganutziu-Deicher)

  • patients with HCC should be screened for HD antigen and antibody for an early diagnosis of hepatocellular carcinoma PMID: 7993113


  • a relatively specific marker for HCC. It is useful in differentiating HCC from primary hepatic cholangiocarcinoma and metastatic tumors when combined with other immunomarkers. PMID: 12170084


  • may be involved in the carcinogenesis and invasiveness of HCC and the determination of HMGA1 can be of great value in predicting the prognosis of patients with HCC. PMID: 16187170


  • associated with intrahepatic metastasis and may be a predictive marker of HCC intrahepatic metastasis. PMID: 15247513


  • could be a sensitive marker for the differential diagnosis of early HCC from precancerous lesion or noncancerous liver, a difficult distinction for pathologists due to very well differentiated histology with little atypia in early HCC. PMID: 12500205


  • serum hTERT mRNA is a novel and available marker for hepatocellular carcinoma (HCC) diagnosis. PMID: 15867214


  • Serum IGF-II level can be used as an independent serologic marker or a complementary tumor marker to AFP for diagnosis of small HCC. PMID: 15841717

Interleukin-2 receptor

  • sIL-2R levels are a more sensitive marker of successful treatment and recurrence of hepatocellular cancer (HCC). PMID: 10082044


  • the expression of Ki-67 is an independent prognostic indicator for patients with HCC after resection and could be of assistance in the decision-making of adjuvant therapy. PMID: 9570240


  • we report for the first time that elevated KiSS-1 expression level in HCC correlates with worsened clinical outcome, as an independent prognostic marker for the aggressiveness of HCC. PMID: 17216189


  • a tumor marker for hepatocellular carcinoma (HCC). Its positivity may reflect HCC-associated cholestasis and/or local tumor invasion. PMID: 16425352

  • serum KL-6 could be a novel tumor marker in the diagnosis and the prediction of prognosis of HCC that may have additive value to the existent markers. PMID: 16202647


  • Serum LINE-1 hypomethylation may serve as a prognostic marker for patients with HCC. PMID: 17303099


  • hepatocytic staining for p28(GANK) is clearly useful in differentiating hepatocyte-originated carcinoma from non-HCC. p28(GANK) may be used as an ancillary marker for the diagnosis of HCC. PMID: 15221469


  • a predictive marker for outcome of postoperative interferon-alpha treatment in patients with hepatitis B virus infection-related hepatocellular carcinoma. PMID: 16948122


  • quantitative immunohistochemical scoring for P53 nuclear accumulation might be more valuable for predicting prognosis of patients after HCC resection than the common qualitative analysis. PMID: 12046070


  • Expression of P-glycoprotein in HCCs is associated with a shorter disease-free interval and shorter survival time. PMID: 8763260


  • Determination of PIVKA-II by this new EIA kit could be useful for the diagnosis of HCC, especially combined with determination of AFP. PMID: 10522021

  • patients with low or negative AFP levels (65%) can be diagnosed using PIVKA II. Abnormal prothrombin is a potential marker for the laboratory diagnosis of hepatocellular carcinoma. PMID: 7498046

  • is synthesized specifically in hepatic cancer cells. PMID: 7686054

  • a useful marker for the prediction of intrahepatic spread and for the prognosis of HCC. PMID: 7513601

  • In patients with larger-sized and multiple HCC, positive results of elevated PIVKA-II were more frequent than those of increased AFP. PMID: 7505217

  • a reliable marker for detecting HCC in patients with liver cirrhosis. PMID: 1371940

  • plasma PIVKA-II level is suggested to be useful as an indicator of warfarin control in patients with thrombotic disease, as a marker of hepatocellular carcinoma, and is particularly of value when assessed in combination with AFP. PMID: 2555040

  • a reliable marker which can reflect the clinical course of HCC. PMID: 2469809


  • may be a prognostic factor for the survival of patients with HCC. PMID: 17459358



  • erythrocyte polyamine may be a useful tumor growth marker in patients with hepatocellular carcinoma. PMID: 11995483


  • Abnormal prothrombin may be useful in the laboratory diagnosis of primary hepatocellular carcinoma. PMID: 6201741


  • a potential prognosis marker and therapeutic target for HCC. PMID: 15150600


  • a significant (P = .032) prognostic factor for patients with HCC. PMID: 7543436


  • can be identified as an independent predictor for recurrence after resection of HCC. PMID: 11376588

TGF alpha

  • Serum TGF alpha levels may provide useful information for the diagnosis of HCC developing in the presence of cirrhosis. PMID: 8635123


  • In HCC, TGF-beta gene may play a defensive role against tumor progression by regulating survivin protein expression and by controlling occurrence of spontaneous apoptosis in tumors. PMID: 16270528

  • TGFbeta1 may be a useful serologic marker in detecting HCCs earlier because it shows higher sensitivity than, with specificity as, AFP in the diagnosis of small HCCs. PMID: 11815974

  • elevated urinary TGF-beta1 level is a tumour marker and predictor of poor survival for cirrhotic hepatocellular carcinoma (HCC). PMID: 9231926


  • a valid surrogate of cirrhosis and a valid marker for the identification of individuals at high-risk for HCC, especially in areas that had a high prevalence of HCV. PMID: 17019738

  • Transcript AA454543 is potentially useful molecular prognostic marker for overall survival after curative partial hepatectomy for HCC. PMID: 15810144


  • a possible new predictive marker for the recurrence of human hepatocellular carcinoma. PMID: 12458564


  • a possible tumor marker for metastasis in human hepatocellular carcinoma. PMID: 9658317

Other Hepatocellular Carcinoma Markers

  • the presence of pityriasis rotunda is a useful pointer to the diagnosis of hepatocellular carcinoma in South African Blacks. PMID: 2543437

  • serum pseudouridine is a useful biochemical marker and that serum pseudouridine and alpha-fetoprotein in combination are considered to serve as complementary markers, for the diagnosis of hepatocellular carcinoma. PMID: 2854011

  • Pityriasis rotunda may prove to be a useful cutaneous marker of hepatocellular carcinoma in South African blacks. PMID: 3015046

  • Assay and subsequent monitoring of serum vitamin B12 and UBCC may prove valuable in the assessment and follow-up of some patients with hepatocellular carcinoma whose alpha fetoprotein levels are normal. PMID: 84776