# Case Report: Serum AKR1B10 as a complementary marker for the detection of AFP-negative hepatocellular carcinoma – a report of two cases

## TL;DR

This case report suggests that serum AKR1B10 can help detect hepatocellular carcinoma cases that are missed by the standard AFP test.

## Contribution

The study highlights AKR1B10 as a potential complementary marker for AFP-negative hepatocellular carcinoma.

## Key findings

- Two hepatitis B-related HCC cases showed elevated AKR1B10 despite being AFP-negative.
- AKR1B10 may serve as a complementary diagnostic marker for AFP-negative HCC.
- Further large-scale studies are needed to confirm the clinical utility of AKR1B10.

## Abstract

Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths worldwide, with chronic hepatitis B and C viral infections being major risk factors. To date, the lack of effective methods for monitoring the progression from viral infection to cancer remains a clinical issue. Alpha-fetoprotein (AFP) is a serum marker used for the detection of HCC; however, AFP levels remain negative in 30–40% of HCC cases and 60–70% of early-stage HCC cases. Aldo-keto reductase 1B10 (AKR1B10) has been reported as a serum marker for HCC. In this study, we report two cases of hepatitis B-related HCC that were persistently AFP-negative but showed a marked increase in serum AKR1B10 levels. These cases illustrate the complementary role of serum AKR1B10 in the diagnosis of AFP-negative HCC, serving as a hypothesis-generating approach. A prospective large-scale study is warranted to define the clinical value of AKR1B10 in AFP-negative HCC.