Ge Tianxiang, Shen Qiujin, Wang Ning, Zhang Yurong, Ge Zhouhong, Chu Wei, Lv Xiufang, Zhao Fengbo, Zhao Weifeng, Fan Jia, Qin Wenxin
Shanghai Medical College of Fudan University, No. 138 Yi-Xueyuan Road, Shanghai, 200032, China.
Med Oncol. 2015 Mar;32(3):59. doi: 10.1007/s12032-014-0367-z. Epub 2015 Feb 6.
The timely diagnosis and effective treatment are essential for improving the survival and prognosis of hepatocellular carcinoma (HCC) patients. Alpha-fetoprotein (AFP) is the most widely used biomarker for diagnosis of HCC, but the low sensitivity and specificity limits its clinical application. In this study, we evaluated the diagnostic capability of the combination of AFP with two novel potential biomarkers, dickkopf-1 (DKK1) and osteopontin (OPN), for HCC in 390 participants including 89 patients with HCC, 36 patients with liver cirrhosis, 65 patients with chronic hepatitis B, and 200 health controls. We found the combination of all three markers as a panel showed a better diagnostic performance than that of AFP alone, with increased AUC [0.948 (95% CI 0.921-0.968) vs. 0.831 (95% CI 0.790-0.867)] and sensitivity (88.76 vs. 71.91%). Moreover, this combination showed a great improvement in diagnosing early-stage HCC patients. In conclusion, the combined use of AFP, DKK1, and OPN as a biomarker panel could enhance the diagnostic ability for HCC.
及时诊断和有效治疗对于提高肝细胞癌(HCC)患者的生存率和预后至关重要。甲胎蛋白(AFP)是诊断HCC最广泛使用的生物标志物,但低敏感性和特异性限制了其临床应用。在本研究中,我们评估了AFP与两种新型潜在生物标志物Dickkopf-1(DKK1)和骨桥蛋白(OPN)联合用于390名参与者(包括89名HCC患者、36名肝硬化患者、65名慢性乙型肝炎患者和200名健康对照)HCC诊断的能力。我们发现,三种标志物作为一个组合显示出比单独使用AFP更好的诊断性能,AUC增加[0.948(95%CI 0.921-0.968)对0.831(95%CI 0.790-0.867)],敏感性提高(88.76对71.91%)。此外,这种组合在诊断早期HCC患者方面有很大改善。总之,联合使用AFP、DKK1和OPN作为生物标志物组合可提高HCC的诊断能力。