Clinical value of alpha-fetoprotein: alpha-fetoprotein-L3 isoform ratio and des-γ-carboxyprothrombin in early diagnosis of HBV-related hepatocellular carcinoma

Abstract

Objective To evaluate the value of different combinations of alpha-fetoprotein （AFP）， alpha-fetoprotein-L3 isoform ratio （AFP-L3%） and des-γ-carboxyprothrombin （DCP） for early diagnosis of hepatitis B virus （HBV）-related hepatocellular carcinoma （HCC）. Methods A total of 167 patients were enrolled in this study， including 100 patients with HCC and 67 patients with infection-related liver cirrhosis （LC）. The levels of serum AFP， AFP-L3% and DCP were detected by chemiluminescence enzyme immunoassay. The receiver operating characteristic （ROC） curve was delineated for subsequent analysis. Results The levels of AFP， AFP-L3% and DCP in HCC patients were significantly higher than those in LC patients （all P < 0.05）. There was no significant difference in AFP and AFP-L3% levels between stage 0 and stage A patients in HCC group （both P > 0.05）. DCP levels in stage 0 patients were significantly lower than those in stage A patients in HCC group （P < 0.05）. The sensitivity and specificity of AFP， AFP-L3% and DCP in the diagnosis of early HCC were 51.5%， 92.5%， 28.3%， and 95.5%， 60.0%， 84.7%， respectively. Analysis of the area under the ROC curve （AUC） results showed that the AUC values of AFP， AFP-L3% and DCP for the diagnosis of early HCC were 0.760， 0.619 and 0.749， respectively. The AUC value of combined detection of AFP and DCP was 0.810， which yielded the highest diagnostic efficiency. Conclusion AFP has important diagnostic value in the diagnosis of early HCC. The combination of AFP and DCP can improve the diagnostic efficiency of HBV-related early HCC.

Keywords

• hepatocellular carcinoma|liver cirrhosis|alpha-fetoprotein|alpha-fetoprotein isoform ratio|des-γ-carboxyprothrombin