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O soro AFP é usado em combinação com ultrassom a cada 6 meses para a vigilância do HCC em c...

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IDBMA-AFP-HCC-AASLD-SURVEILLANCE
TipoRelevância terapêutica
Estadoreviewed 2026-05-18 | actionability review required
DoençasDIS-HCC
FontesSRC-AASLD-HCC-2023 SRC-NCCN-HCC-2025

Fatos de ação

BiomarcadorBIO-AFP
VarianteAlfa-fetoproteína — Vigilância do CHC em cirróticos + VHB crônico
DoençaDIS-HCC
Nível ESCATIIIA
Combinações recomendadasCirrótico de qualquer etiologia (Child-Pugh A/B7): US + AFP a cada 6 meses, HBV crônico de alto risco (homens assianos/africanos ≥40, mulheres ≥50, história familiar, HBEAg+, ADN HB VHB elevado): US +AFP a todos os 6 meses mesmo sem cirrose, AFP >20 ng/ml ou trajetória crescente com US negativo: TC multifásica ou RM por LI-RADS
Contraindicated monotherapyA AFP isoladamente (sem imagens) é insuficiente para a vigilância do HCC — AASLD não avalia a triagem apenas com AFP
Resumo das provasSerum 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.

Notas

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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Relevância terapêutica