肝细胞癌
医学
胃肠病学
内科学
切断
甲胎蛋白
入射(几何)
曲线下面积
量子力学
光学
物理
作者
Judith Ertle,Dominik Heider,Marc Wichert,Benedikt Keller,Robert Kueper,Philip Hilgard,Guido Gerken,Joerg F. Schlaak
出处
期刊:Digestion
[S. Karger AG]
日期:2013-01-01
卷期号:87 (2): 121-131
被引量:92
摘要
<b><i>Background and Aim:</i></b> The incidence of hepatocellular carcinoma (HCC) is increasing in western countries. Despite its low sensitivity, the diagnosis of HCC still depends on detection of α-fetoprotein (AFP). Therefore, the aim of this study was to evaluate the combined analysis of AFP and des-γ-carboxy prothrombin (DCP) in a European cohort. <b><i>Methods:</i></b> We performed a single-center study (164 HCC/422 controls), in which the serum concentrations of AFP and DCP were determined. <b><i>Results:</i></b> AFP and DCP were elevated in HCC patients compared to controls (p < 0.0001). By combination of AFP and DCP, the sensitivity was improved from 28.7% for AFP (cutoff 400 ng/ml; AFP at cutoff 10 ng/ml: 54.9%) to 78.0% using cutoffs of 10 ng/ml for AFP and 5 ng/ml for DCP (DCP alone, cutoff 5 ng/ml: 63.4%). Among early-stage patients, the sensitivity increased from 20% for AFP (cutoff 400 ng/ml; AFP at cutoff 10 ng/ml: 38%) to 55% in combination (DCP alone, cutoff 5 ng/ml: 47%). The area under the curve (AUC) for AFP and DCP was similar (AFP: 0.88; DCP: 0.87; combined: 0.91). Among non-cirrhotic patients, DCP (AUC: 0.93) showed a better performance than AFP (AUC: 0.84). Especially patients with non-alcoholic steatohepatitis had a high percentage of DCP-positive tumors. <b><i>Conclusion:</i></b> The data suggest that AFP alone is not sufficient for the serological diagnosis of HCC in European patients, while a combination of AFP and DCP can increase the sensitivity even in early-stage patients.
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