Division of Gastroenterology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
J Gastroenterol Hepatol. 2012 Mar;27(3):547-52. doi: 10.1111/j.1440-1746.2011.06896.x.
Although alpha-fetoprotein (AFP) is a widely used serological marker for hepatocellular carcinoma (HCC), its utility is limited due to its unsatisfactory sensitivity. Meanwhile, a newly developed immunoassay-DR-70-has been reported to have a good sensitivity for HCC in a small-scale study. The aim of this study was to determine the clinical value of DR-70 for the surveillance of HCC.
Serum levels of DR-70 and AFP were measured in 103 patients with HCC, 50 healthy volunteers, and 33 patients with chronic liver disease. In addition, we investigated the prognostic value of DR-70 in patients with HCC correlating with the clinical staging-Cancer of the Liver Italian Program (CLIP) score and Barcelona Clinic Liver Cancer (BCLC) classification.
Based on the receiver operating characteristic curve with area under the curve of 0.836, the DR-70 cut-off value for detecting HCC was determined to be 0.75 µg/mL. DR-70 provided a sensitivity of 81.6% and a specificity of 77.1%, and correlated well with the CLIP score and BCLC classification. The combination of DR-70 and AFP increased the sensitivity to 91.2%. The prognosis for patients with HCC with DR-70 level > 0.75 µg/mL was worse than that for those with DR-70 ≤ 0.75 µg/mL. Among the patients with early stage HCC (CLIP score 0-2), DR-70 > 0.75 µg/mL independently predicted a poor survival.
DR-70 immunoassay is complementary to AFP for the detection of HCC and has a good correlation with clinical staging and prognosis.
甲胎蛋白（AFP）虽然是一种广泛应用于肝细胞癌（HCC）的血清学标志物，但由于其敏感性不理想，其应用受到限制。同时，一项新开发的免疫测定法-DR-70-在一项小规模研究中被报道对 HCC 具有良好的敏感性。本研究旨在确定 DR-70 用于 HCC 监测的临床价值。
检测了 103 例 HCC 患者、50 名健康志愿者和 33 例慢性肝病患者的血清 DR-70 和 AFP 水平。此外，我们还研究了 DR-70 与临床分期-意大利肝癌计划（CLIP）评分和巴塞罗那临床肝癌（BCLC）分类相关的 HCC 患者的预后价值。
基于曲线下面积为 0.836 的受试者工作特征曲线，确定 DR-70 检测 HCC 的截断值为 0.75 µg/mL。DR-70 的敏感性为 81.6%，特异性为 77.1%，与 CLIP 评分和 BCLC 分类相关性良好。DR-70 与 AFP 的联合检测可提高至 91.2%的敏感性。DR-70 水平>0.75 µg/mL 的 HCC 患者的预后比 DR-70 ≤0.75 µg/mL 的患者差。在早期 HCC（CLIP 评分 0-2）患者中，DR-70>0.75 µg/mL 独立预测不良生存。
DR-70 免疫测定法对 HCC 的检测是 AFP 的补充，与临床分期和预后有良好的相关性。
