Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan.
Cancer Sci. 2012 May;103(5):921-5. doi: 10.1111/j.1349-7006.2012.02232.x. Epub 2012 Mar 8.
Des-gamma-carboxy prothrombin (DCP) is a useful tumor marker for hepatocellular carcinoma (HCC), but its utility is limited in patients taking vitamin K antagonists. We evaluated the NX-DCP ratio, a newly developed method to measure serum DCP, for its ability to identify DCP elevation induced by HCC in this patient subpopulation. Conventional DCP measurements and the NX-DCP ratio were compared in patients with and without HCC, all of whom were taking the vitamin K antagonist warfarin. We found no differences in conventional DCP measurements between patients with and without HCC due to warfarin treatment. In contrast, the NX-DCP ratio was significantly higher in patients with HCC; the NX-DCP ratio in all patients without HCC was <1.50. When the cut-off was fixed at 1.50, sensitivity and specificity for HCC diagnosis were 60.0% and 100.0%, respectively, which are comparable to those of conventional DCP measurements in patients not taking warfarin. The novel NX-DCP ratio identifies patients on warfarin with elevated DCP due to HCC and is useful as a tumor marker for HCC in this patient subpopulation.
去γ羧基凝血酶原（DCP）是肝细胞癌（HCC）的一种有用的肿瘤标志物，但在服用维生素 K 拮抗剂的患者中其应用受到限制。我们评估了一种新的 DCP 测量方法 NX-DCP 比值，以评估其在该患者亚群中识别由 HCC 引起的 DCP 升高的能力。比较了服用维生素 K 拮抗剂华法林的 HCC 患者和非 HCC 患者的常规 DCP 测量值和 NX-DCP 比值。由于华法林治疗，两组患者的常规 DCP 测量值没有差异。相比之下，患有 HCC 的患者的 NX-DCP 比值明显更高；所有未患有 HCC 的患者的 NX-DCP 比值均<1.50。当截止值固定在 1.50 时，HCC 诊断的敏感性和特异性分别为 60.0%和 100.0%，与未服用华法林的患者的常规 DCP 测量值相当。新型 NX-DCP 比值可识别因 HCC 而 DCP 升高的服用华法林的患者，是该患者亚群中 HCC 的有用肿瘤标志物。
