Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China.
Beijing Key Laboratory for HIV/AIDS Research, Beijing, China.
J Int Med Res. 2020 Mar;48(3):300060519889270. doi: 10.1177/0300060519889270. Epub 2019 Dec 18.
This study aimed to explore the use of different combinations of alpha-fetoprotein (AFP), agglutinin-reactive AFP (AFP-L3), and des-gamma-carboxyprothrombin (DCP) for the early diagnosis of hepatocellular carcinoma (HCC) in patients with hepatitis B virus (HBV)-associated liver cirrhosis (LC).
There were 167 subjects, including 100 with HCC and 67 with LC, who were enrolled into this study. Serum AFP, AFP-L3, and DCP levels were detected by chemiluminescent enzyme immunoassay and analyzed using the receiver operating characteristics (ROC) method.
The sensitivity and specificity of AFP and DCP for differentiating between early HCC and HBV-associated LC were 51.5% and 92.5%, and 60.0% and 84.7%, respectively. Comparative analysis of ROC curves showed no significant difference in the area under the curve (AUC) for AFP and DCP. Moreover, the combination of AFP and DCP showed the largest AUC value with a diagnostic sensitivity and specificity of 67% and 83.1%, respectively.
These results suggest that AFP is the best single biomarker for distinguishing between HBV-associated LC and early HCC induced by HBV. However, the combination of AFP and DCP can enhance the diagnostic value of AFP for differentiating between these diseases.
本研究旨在探讨甲胎蛋白（AFP）、凝集素反应性 AFP（AFP-L3）和脱γ-羧基凝血酶原（DCP）不同组合在乙型肝炎病毒（HBV）相关肝硬化（LC）患者肝细胞癌（HCC）早期诊断中的应用。
本研究共纳入 167 例患者，其中 HCC 患者 100 例，LC 患者 67 例。采用化学发光酶免疫分析法检测血清 AFP、AFP-L3 和 DCP 水平，并采用受试者工作特征（ROC）曲线分析。
AFP 和 DCP 区分早期 HCC 和 HBV 相关 LC 的敏感性和特异性分别为 51.5%和 92.5%、60.0%和 84.7%。ROC 曲线比较分析显示，AFP 和 DCP 的曲线下面积（AUC）无显著差异。此外，AFP 和 DCP 联合检测的 AUC 值最大，诊断敏感性和特异性分别为 67%和 83.1%。
这些结果表明，AFP 是区分 HBV 相关 LC 和 HBV 诱导的早期 HCC 的最佳单项生物标志物。然而，AFP 和 DCP 的联合检测可以提高 AFP 区分这些疾病的诊断价值。
