Picture of classic books on shelf

Literary linguistics: Open Access research in English language

Strathprints makes available Open Access scholarly outputs by English Studies at Strathclyde. Particular research specialisms include literary linguistics, the study of literary texts using techniques drawn from linguistics and cognitive science.

The team also demonstrates research expertise in Renaissance studies, researching Renaissance literature, the history of ideas and language and cultural history. English hosts the Centre for Literature, Culture & Place which explores literature and its relationships with geography, space, landscape, travel, architecture, and the environment.

Explore all Strathclyde Open Access research...

Alpha-fetoprotein detection of hepatocellular carcinoma leads to a standardized analysis of dynamic AFP to improve screening based detection

Bird, Thomas G. and Dimitropoulou, Polyxeni and Turner, Rebecca M. and Jenks, Sara J. and Cusack, Pearce and Hey, Shiying and Blunsum, Andrew and Kelly, Sarah and Sturgeon, Catharine and Hayes, Peter C. and Bird, Sheila M. (2016) Alpha-fetoprotein detection of hepatocellular carcinoma leads to a standardized analysis of dynamic AFP to improve screening based detection. PLOS One, 11 (6). ISSN 1932-6203

[img]
Preview
Text (Bird-etal-PLOS-alpha-fetoprotein-detection-of-hepatocellular-carcinoma)
Bird_etal_PLOS_alpha_fetoprotein_detection_of_hepatocellular_carcinoma.pdf
Final Published Version
License: Creative Commons Attribution 4.0 logo

Download (2MB) | Preview

Abstract

Detection of hepatocellular carcinoma (HCC) through screening can improve outcomes. However, HCC surveillance remains costly, cumbersome and suboptimal. We tested whether and how serum Alpha-Fetoprotein (AFP) should be used in HCC surveillance. Record linkage, dedicated pathways for management and AFP data-storage identified i) consecutive highly characterised cases of HCC diagnosed in 2009-14 and ii) a cohort of ongoing HCC-free patients undergoing regular HCC surveillance from 2009. These two well-defined Scottish patient cohorts enabled us to test the utility of AFP surveillance. Of 04 cases of HCC diagnosed over 6 years, 42% (129) were identified by a dedicated HCC surveillance programme. Of these 129, 47% (61) had a detectable lesion first identified by screening ultrasound (US) but 38% (49) were prompted by elevated AFP. Despite pre-HCC diagnosis AFP >20kU/L being associated with poor outcome, 'AFP-detected' tumours were offered potentially curative management as frequently as 'US-detected' HCCs; and had comparable survival. Linearity of serial log10 -transformed AFPs in HCC cases and in the screening 'HCC-free' cohort (n = 1509) provided indicators of high-risk AFP behaviour in HCC cases. An algorithm was devised in static mode, then tested dynamically. A case/control series in hepatitis C related disease demonstrated highly significant detection (p-5) of patients at high risk of developing HCC. These data support the use of AFP in HCC surveillance. We show proof-of-principle that an automated and further refineable algorithmic interpretation of AFP can identify patients at higher risk of HCC. This approach could provide a cost-effective, user-friendly and much needed addition to US surveillance.