Department of Internal Medicine and Systemic Diseases, Catania University, Catania, Italy.
Minerva Med. 2011 Oct;102(5):363-71.
The hepatocellular carcinoma (HCC) is one of the most common malignant tumors. It carries a poor survival rate and has an increasing incidence worldwide. In most cases, HCC is diagnosed at a late stage. Therefore, the prognosis of patients with HCC is generally poor and has a less than 5% 5-year survival rate. The aim of this study was compare the accuracy of α-fetoprotein (AFP), des-γ- carboxy prothrombin (DCP), squamous cell carcinoma antigen-immunoglobulin M complexes (SCCA-IgM Cs) in the early diagnosis and in the prognosis of HCC. A literature search identified the markers for hepatocellular carcinoma. A search of the literature was made using cancer literature and the PubMed database for the following keywords: "markers and HCC", "α-fetoprotein (AFP) and HCC", "Des-γ-carboxy prothrombin"(DCP) and HCC, "squamous cell carcinoma antigen-immunoglobulin M complexes" (SCCA-IgM Cs). Despite the large number of studies devoted to the immunohistochemistry of HCC, at the present time, the absolute positive and negative markers for HCC are still lacking, and even those characterized by very high sensitivity and specificity do not have an universal diagnostic usefulness. In conclusion none of the three biomarkers (AFP, DCP, SCCA-IgM Cs) is optimal. According to recent reviews, these biomarkers should be measured simultaneously and in combination with imaging techniques to increase the sensitivity, specificity, diagnostic accuracy and to make a reliable prognosis. Currently the recommended screening strategy for patients with cirrhosis includes the determination of serum AFP levels and an abdominal ultrasound every six months to detect HCC at an earlier stage.
肝细胞癌（HCC）是最常见的恶性肿瘤之一。它的生存率较差，且全球发病率呈上升趋势。在大多数情况下，HCC 被诊断为晚期。因此，HCC 患者的预后一般较差，5 年生存率低于 5%。本研究旨在比较甲胎蛋白（AFP）、脱γ-羧基凝血酶原（DCP）、鳞状细胞癌抗原-免疫球蛋白 M 复合物（SCCA-IgM Cs）在 HCC 早期诊断和预后中的准确性。通过文献检索确定了肝癌标志物。使用癌症文献和 PubMed 数据库，以下列关键词搜索文献：“标志物和 HCC”、“甲胎蛋白（AFP）和 HCC”、“脱γ-羧基凝血酶原”（DCP）和 HCC、“鳞状细胞癌抗原-免疫球蛋白 M 复合物”（SCCA-IgM Cs）。尽管有大量研究致力于 HCC 的免疫组织化学，但目前仍然缺乏 HCC 的绝对阳性和阴性标志物，即使是那些具有非常高敏感性和特异性的标志物也没有普遍的诊断用途。综上所述，这三种生物标志物（AFP、DCP、SCCA-IgM Cs）均不理想。根据最近的综述，这些生物标志物应同时测量，并与影像学技术相结合，以提高敏感性、特异性、诊断准确性并做出可靠的预后。目前，建议对肝硬化患者进行筛查，包括定期检测血清 AFP 水平和腹部超声，以更早地发现 HCC。
