Mittal Ankush, Gupta Satrudhan Pd, Sathian Brijesh, Sreedharan Jayadevan, Poudel Bibek, Yadav Shambhu Kumar, Pandeya Dipendra Raj
Biochemistry, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal.
Asian Pac J Cancer Prev. 2012;13(11):5773-5. doi: 10.7314/apjcp.2012.13.11.5773.
To assess the diagnostic and prognostic value of AFP and des-gamma-carboxyprothrombin (DCP) in combination and alone for hepatocellular carcinoma.
A case control study carried out in the Department of Biochemistry of Manipal College of Medical Sciences, Pokhara, Nepal between 1st January 2010 and 31st December 2011. The variables collected were age, gender, BMI, total proteins, albumin, AST, ALT, total bilirubin, DCP, AFP. Approval for the study was obtained from the institutional research ethical committee. Estimation of AFP was performed by ELISA reader for all cases. Analysis was done using descriptive statistics and confidence interval (CI). The data was analyzed using Excel 2003, R 2.8.0 Statistical Package for the Social Sciences (SPSS) for Windows Version 16.0 (SPSS Inc; Chicago, IL, USA) and the EPI Info 3.5.1 Windows Version.
The mean age of HCC cases was 53.6±14.93 yrs. The percentage of females was less than males in both cases (23%) and controls (29%). The specificity of DCP reached 100% when its values was equal or greater than 150 (MAU/ml) for 0, 3, 6, 9, 12 months preceding the diagnosis of HCC. Similarly, the specificity for AFP was also nearly 100% when its value was equal or greater than 200 ng/ml 0, 3, 6, 9, 12 months earlier to the finding of HCC. The specificity of DCP (≥40 MAU/mL) and AFP(≥20 ng/mL) in combination was 93%, 97%, 95%, 96%, 97% in respect to 0, 3, 6, 9, 12 months prior to the diagnosis of HCC.
The combination of both DCP and AFP will improve the finding of initial HCC and the sensitivity of these markers was utmost at the time of HCC identification and noticeably lesser at former time points.
评估甲胎蛋白（AFP）和异常凝血酶原（DCP）单独及联合检测对肝细胞癌的诊断和预后价值。
2010年1月1日至2011年12月31日在尼泊尔博卡拉马尼帕尔医学院生物化学系开展了一项病例对照研究。收集的变量包括年龄、性别、体重指数、总蛋白、白蛋白、谷草转氨酶、谷丙转氨酶、总胆红素、DCP、AFP。本研究获得了机构研究伦理委员会的批准。对所有病例均采用酶联免疫吸附测定仪检测AFP。采用描述性统计和置信区间（CI）进行分析。使用Excel 2003、适用于Windows版本16.0的社会科学统计软件包R 2.8.0（SPSS公司；美国伊利诺伊州芝加哥）以及EPI Info 3.5.1 Windows版本对数据进行分析。
肝细胞癌病例的平均年龄为53.6±14.93岁。病例组（23%）和对照组（29%）中女性的比例均低于男性。在肝细胞癌诊断前0、3、6、9、12个月，当DCP值等于或大于150（毫吸光度单位/毫升）时，其特异性达到100%。同样，在发现肝细胞癌前0、3、6、9、12个月，当AFP值等于或大于200纳克/毫升时，其特异性也接近100%。在肝细胞癌诊断前0、3、6、9、12个月，DCP（≥40毫吸光度单位/毫升）和AFP（≥20纳克/毫升）联合检测的特异性分别为93%、97%、95%、96%、97%。
DCP和AFP联合检测可提高肝细胞癌的早期发现率，这些标志物在肝细胞癌确诊时的敏感性最高，而在之前的时间点明显较低。
