Zhongguo quanke yixue (Jun 2022)
Performance of Serum m3AchR-Ab for Alpha-fetoprotein-negative Hepatocellular Carcinoma Diagnosis
Abstract
Background Alpha-fetoprotein (AFP) is a common diagnostic marker for hepatocellular carcinoma (HCC) , a highly malignant cancer, but its sensitivity is only 41%-65%, and the rate of missed diagnosis is relatively high. Therefore, there is an urgent need to develop new diagnostic markers and methods to improve the detection rate of AFP-negative and other types of HCC. Objective To assess the diagnostic efficacy of muscarinic acetylcholine receptor m3 autoantibody (m3AchR-Ab) in AFP-negative HCC, and to explore the diagnostic value of m3AchR-Ab in HCC. Methods Participants (n=257) were selected from the First Affiliated Hospital of Xinjiang Medical University, including 90 with confirmed diagnosis of HCC, 89 with liver cirrhosis, hepatic hemangioma or other benign liver diseases, and 78 healthy controls. ELISA was the technique used for measuring the serum m3AchR-Ab level in venous blood samples of all cases stored in the serum repository of the hospital from November 2011 to September 2015. Serum m3AchR-Ab levels were compared in the three groups. The associations of serum m3AchR-Ab level with gender, age, size (the maximum diameter) of HCC, number and TNM stage of HCC, prevalence of lymph node metastasis, distant metastasis and HBsAg positivity in HCC patients were analyzed. The efficacy of m3AchR-Ab in the diagnosis of AFP-negative HCC was evaluated by the receiver operating characteristic (ROC) curve. Results HCC patients had higher serum m3AchR-Ab level than benign liver disease patients and healthy controls (P<0.05) . The level of m3AchR-Ab was correlated with the size and TNM stage of HCC, as well as prevalence of lymph node metastasis and HBsAg positivity (P< 0.05) . The area under the ROC curve of serum m3AchR-Ab in the diagnosis of AFP-negative HCC was 0.69〔95%CI (0.54, 0.83) 〕, with 64.00% sensitivity and 91.02% specificity when 74.00 ng/ml was chosen as the optimal cut-off value. The area under the ROC curve of m3AchR-Ab with AFP in serum in diagnosing HCC was 0.90〔95%CI (0.85, 0.95) 〕, with 90.00% sensitivity and 88.02% specificity. Conclusion Serum m3AchR-Ab level is a potential diagnostic maker for AFP-negative HCC, and its combination with serum AFP level could produce higher diagnostic efficiency for HCC, which may be a reference for further research on novel diagnostic markers for HCC.
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