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Le sérum AFP est utilisé en association avec l'échographie tous les 6 mois pour la surveillance du HCC en...

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IDBMA-AFP-HCC-AASLD-SURVEILLANCE
TypePertinence thérapeutique
Étatreviewed 2026-05-18 | actionability review required
MaladiesDIS-HCC
SourcesSRC-AASLD-HCC-2023 SRC-NCCN-HCC-2025

Faits relatifs à l ' action en justice

BiomarqueurBIO-AFP
VarianteAlpha-fétoprotéine — Surveillance du HCC dans les cirrhotiques + VHB chronique
MaladieDIS-HCC
Niveau ESCATIIIA
Combinaisons recommandéesCirrhotic of any aetiology (Child-Pugh A/B7): US + AFP every 6 months, Chronic HBV high-risk (Asian/African ancestry men ≥40, women ≥50, family history, HBeAg+, high HBV DNA): US + AFP every 6 months even without cirrhosis, AFP >20 ng/mL or rising trajectory with negative US: multiphasic CT or MRI per LI-RADS
Contre-indiqué en monothérapieL'AFP seule (sans imagerie) est insuffisante pour la surveillance du HCC — L'AASLD n'approuve pas le dépistage uniquement par AFP
Résumé des faitsSerum AFP is used in combination with ultrasound every 6 months for HCC surveillance in cirrhotic patients of any aetiology (Child-Pugh A/B7, candidates for treatment) and in non-cirrhotic chronic HBV with elevated HCC risk per AASLD HCC 2023. US-alone sensitivity is suboptimal (~63%); US + AFP raises sensitivity for early-stage HCC to ~70-80% with acceptable specificity (~85-90%). AFP threshold typically >20 ng/mL (some guidelines >7 ng/mL with risk-stratified cutoffs). Rising AFP trajectory is more informative than single value. AFP elevation also occurs in chronic hepatitis flares, regenerative nodules, germ-cell tumours, and gestation — interpret in context. Diagnostic workup of rising AFP: multiphasic CT or MRI per LI-RADS criteria. AFP-L3 fraction and DCP (PIVKA-II) are adjunct markers in some practices. ESCAT IIIA — AFP directs HCC diagnostic workup / surveillance cadence.

Notes

STUB pending two-Co-Lead signoff. AASLD-aligned HCC surveillance Indication entities are partially authored — closest existing entities: ind_a1at_deficiency_hcc_lung_prevention_surveillance and the HCV/HBV prevention bundle. A general IND-CIRRHOSIS-HCC-SURVEILLANCE entity (aetiology-agnostic, gated on Child-Pugh class) is a future authoring task. AFP-L3 and DCP/PIVKA-II are adjunct markers not consistently guideline-endorsed for surveillance; render layer should not surface as primary surveillance. Special context: in post-SVR12 HCV cirrhotics, HCC risk persists at reduced level — AFP + US surveillance continues lifelong in those who reached F3/F4 fibrosis before cure.

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Pertinence thérapeutique