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The Expressions of CD44, CD90 and Alpha Fetoprotein Biomarkers in Indonesian Patients with Advanced Liver Disease: an Observational Study

ACTA MEDICA INDONESIANA · Vol. 51 No. 2 (2019)

ISSN
2338-2732, 0125-9326
Published
2019-08-05
Publisher
The Indonesian Society of Internal Medicine
Language
eng

Abstract

Background: increased serum alpha fetoprotein (AFP) levels are often found in patients with advanced hepatocellular carcinoma (HCC). Cluster Differentiation 44 (CD44) and CD90 are stem cell biomarkers that have been assumed as the early HCC markers and associated with onset and progressivity of HCC. The study related to HCC stem cell has not been available in Indonesia. The present study aimed to evaluate the expression of cancer stem cell markers (CD44, CD90) and AFP levels in patients with advanced liver disease. Methods: an observational study was conducted in 41 patients with chronic hepatitis B and/or C infection, liver cirrhosis, and HCC at dr. Saiful Anwar General Hospital. CD44 and CD90 expressions were measured with flow cytometry, and AFP serum levels with ELISA. Data on patient characteristics were evaluated using bivariate and multivariate statistical analysis (One-way ANOVA, Mann-Whitney, Chi-Square, Kruskal-Wallis). Data of CD44, CD90 and AFP were analyzed using Kruskal Wallis test with a significance value of p<0.05, and diagnostic power was analyzed using receiver operating characteristic (ROC). Results: the subjects of our study were 16 patients with chronic hepatitis, 15 patients with liver cirrhosis, and 10 patients with HCC. There was a significant difference regarding CD44+CD90+ and AFP among those three groups (p=0.001; p=0.000) specifically in chronic hepatitis compared to liver cirrhosis (p=0.002; p=0.000) and HCC (p=0.002; p=0.000) respectively. ROC analysis showed the best diagnostic power for the combination of CD44+CD90+ and AFP (AUC=0.981; p=0.000). Conclusion: there are higher expressions of CD44+CD90+ and serum AFP levels in patients with HCC compared to the other two groups (those with chronic hepatitis and liver cirrhosis). The combination of both parameters has the best diagnostic power of HCC.

Keywords

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40 authors · 221 co-authorship links · showing the 40 most connected

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Co-authorOrganisationJoint articles
Arismunandar ArismunandarAffiliation unknown2
Nurhikmah HAffiliation unknown2
Supriono SuprionoAffiliation unknown2
Mochamad FachrurezaAffiliation unknown2
Bogi Pratomo WibowoAffiliation unknown2
Irene SaveriaAffiliation unknown1
Dian HasanahAffiliation unknown1
Amalia Nurul HatinahAffiliation unknown1
Rini R BachtiarAffiliation unknown1
Irsan HasanAffiliation unknown1
Juferdy KurniawanAffiliation unknown1
Fauzi YusufAffiliation unknown1
Nenny AgustantiAffiliation unknown1
Ulfa KholiliAffiliation unknown1
Fandy GosalAffiliation unknown1
Gita ApriliciaAffiliation unknown1
Hery Djagat PurnomoAffiliation unknown1
Cecilia O PermatawediAffiliation unknown1
Tehar Karo-KaroAffiliation unknown1
Haris WiditaAffiliation unknown1
Aritantri DarmayaniAffiliation unknown1
Arif Nur WidodoAffiliation unknown1
Saptino MiroAffiliation unknown1
Suyata SuyataAffiliation unknown1
Catharina TriwikatmaniAffiliation unknown1
I Ketut MariadiAffiliation unknown1
Zahra SafiraAffiliation unknown1
Andika Agus BudiartoAffiliation unknown1
Andi WahedAffiliation unknown1
Hasnawi HarisAffiliation unknown1
Dian HandayaniAffiliation unknown1
Nabila RamadhaniAffiliation unknown1
Dewi SantosaningsihAffiliation unknown1
Novita Apramadha Kartika SariAffiliation unknown1
Natasya Adiba ZahrahAffiliation unknown1
Sri WidyartiAffiliation unknown1
Aulanni’am Aulanni’amAffiliation unknown1

Affiliations come from OpenAlex; journal OAI-PMH metadata carries none. Authors without an OpenAlex ID are matched by name, which can merge or split people.

Metadata source: OAI-PMH (metadata jurnal) http://www.actamedindones.org/index.php/ijim/oai, first harvested 8 Nov 2026, last seen 8 Nov 2026.
Original metadata (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en-US">The Expressions of CD44, CD90 and Alpha Fetoprotein Biomarkers in Indonesian Patients with Advanced Liver Disease: an Observational Study</dc:title>
	<dc:creator>Mustika, Syifa</dc:creator>
	<dc:creator>Wijaya, Hengki</dc:creator>
	<dc:creator>Pratomo, Bogi</dc:creator>
	<dc:subject xml:lang="en-US">AFP</dc:subject>
	<dc:subject xml:lang="en-US">Biomarker</dc:subject>
	<dc:subject xml:lang="en-US">Chronic Hepatitis</dc:subject>
	<dc:subject xml:lang="en-US">liver cirrhosis</dc:subject>
	<dc:subject xml:lang="en-US">HCC</dc:subject>
	<dc:description xml:lang="en-US">Background: increased serum alpha fetoprotein (AFP) levels are often found in patients with advanced hepatocellular carcinoma (HCC). Cluster Differentiation 44 (CD44) and CD90 are stem cell biomarkers that have been assumed as the early HCC markers and associated with onset and progressivity of HCC. The study related to HCC stem cell has not been available in Indonesia. The present study aimed to evaluate the expression of cancer stem cell markers (CD44, CD90) and AFP levels in patients with advanced liver disease. Methods: an observational study was conducted in 41 patients with chronic hepatitis B and/or C infection, liver cirrhosis, and HCC at dr. Saiful Anwar General Hospital. CD44 and CD90 expressions were measured with flow cytometry, and AFP serum levels with ELISA. Data on patient characteristics were evaluated using bivariate and multivariate statistical analysis (One-way ANOVA, Mann-Whitney, Chi-Square, Kruskal-Wallis). Data of CD44, CD90 and AFP were analyzed using Kruskal Wallis test with a significance value of p&amp;lt;0.05, and diagnostic power was analyzed using receiver operating characteristic (ROC). Results: the subjects of our study were 16 patients with chronic hepatitis, 15 patients with liver cirrhosis, and 10 patients with HCC. There was a significant difference regarding CD44+CD90+ and AFP among those three groups (p=0.001; p=0.000) specifically in chronic hepatitis compared to liver cirrhosis (p=0.002; p=0.000) and HCC (p=0.002; p=0.000) respectively. ROC analysis showed the best diagnostic power for the combination of CD44+CD90+ and AFP (AUC=0.981; p=0.000). Conclusion: there are higher expressions of CD44+CD90+ and serum AFP levels in patients with HCC compared to the other two groups (those with chronic hepatitis and liver cirrhosis). The combination of both parameters has the best diagnostic power of HCC.</dc:description>
	<dc:publisher xml:lang="en-US">The Indonesian Society of Internal Medicine</dc:publisher>
	<dc:date>2019-08-05</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:type xml:lang="en-US">The study was cross sectional in design and conducted in 2016-2017 in dr. Saiful Anwar General Hospital Malang, Indonesia. This study had been approved by ethical committee of dr. Saiful Anwar General Hospital Malang. Subjects of the study were adult with</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>http://www.actamedindones.org/index.php/ijim/article/view/718</dc:identifier>
	<dc:source xml:lang="en-US">Acta Medica Indonesiana; Vol. 51 No. 2 (2019): Acta Medica Indonesiana; 137</dc:source>
	<dc:source>2338-2732</dc:source>
	<dc:source>0125-9326</dc:source>
	<dc:language>eng</dc:language>
	<dc:relation>http://www.actamedindones.org/index.php/ijim/article/view/718/pdf</dc:relation>
	<dc:rights xml:lang="en-US">Copyright (c) 2019 Acta Medica Indonesiana</dc:rights>
</oai_dc:dc>