HCC-ART 评分：一种用于早期诊断肝细胞癌的简单、高敏感、高特异的检测方法：一项大规模、多中心研究。
HCC-ART score, a simple, highly sensitive and specific test for early diagnosis of hepatocellular carcinoma: a large-scale, multicentre study.
机构信息
R & D Department, Biotechnology Research Center, PO Box (14), 23 July Street, Industrial Zone, New Damietta 34517, Egypt.
出版信息
Br J Cancer. 2013 Sep 17;109(6):1657-65. doi: 10.1038/bjc.2013.481. Epub 2013 Aug 27.
BACKGROUND
A simple scoring system is needed to discriminate HCC from patients with chronic liver diseases (CLD). The simplest score would be one that requires only variables that can be documented simply from routine laboratory tests without the need for sophisticated tests.
METHODS
Data from the estimation group (1351 patients) and the validation group (2208 patients) were retrospectively analysed. Liver fibrosis-negative control and liver cirrhosis were compared with HCC. Area under ROC curve (AUC) were used to develop HCC-α-fetoprotein-routine test (HCC-ART).
RESULTS
Hepatocellular carcinoma-AFP-routine test showed diagnostic accuracy for liver cirrhosis vs HCC with ROC curves of 0.99%, sensitivity of 97%, and specificity of 96% in the estimation, and 0.95%, 90%, and 83%, respectively, in the validation. Sensitivity (97%) and specificity (100%) were obtained to discriminate HCC from liver fibrosis. Area under curve for AFP at 400 U l(-1) was 0.70, sensitivity was 41%, and specificity was 99% in the estimation, and 0.77%, 54%, and 99%, respectively, in the validation. The AUC for HCC-ART in HCC with single tumour, absent vascular invasion, size <2 cm and CLIP score (0-1) were 0.95, 0.93, 0.86, 0.87, respectively, compared with 0.72, 0.71, 0.71, 0.50, respectively, for AFP.
CONCLUSION
Hepatocellular carcinoma-AFP-routine test could increase the accuracy of HCC screening and surveillances and could be used worldwide without extra efforts.
背景
需要有一种简单的评分系统来区分 HCC 与慢性肝病（CLD）患者。最简单的评分系统只需使用可以从常规实验室检查中简单记录的变量，而无需复杂的检查。
方法
回顾性分析了估计组（1351 例）和验证组（2208 例）的数据。将无肝纤维化对照组和肝硬化与 HCC 进行比较。ROC 曲线下面积（AUC）用于开发 HCC-α-胎蛋白-常规检测（HCC-ART）。
结果
HCC-ART 对肝硬化与 HCC 的诊断准确性在估计组的 ROC 曲线中分别为 0.99%、97%和 96%，在验证组中分别为 0.95%、90%和 83%。在鉴别 HCC 与肝纤维化时，HCC-ART 的敏感性（97%）和特异性（100%）均较高。在 AFP 为 400 U l(-1) 时，AUC 为 0.70，在估计组中的敏感性为 41%，特异性为 99%，在验证组中的敏感性为 0.77%、54%和 99%。在单肿瘤、无血管侵犯、<2cm 和 CLIP 评分（0-1）的 HCC 中，HCC-ART 的 AUC 分别为 0.95、0.93、0.86 和 0.87，而 AFP 的 AUC 分别为 0.72、0.71、0.71 和 0.50。
结论
HCC-ART 可提高 HCC 筛查和监测的准确性，无需额外努力即可在全球范围内使用。
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