Li Youdi, Chen Yanfei, Chen Jiu
Department of Traditional Chinese Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China.
J Coll Physicians Surg Pak. 2020 Feb;30(2):134-138. doi: 10.29271/jcpsp.2020.02.134.
To determine the diagnostic value of alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) for patients with non-B, non-C hepatocellular carcinoma (NBNC HCC).
Observational study.
The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China, from June 2016 to June 2019.
Patients with NBNC HCC diagnosed by histology were inducted after curative resection. Serum levels of AFP and DCP were determined. Their receiver operating characteristic (ROC) curves were generated, and the area under the ROC curve (AUC) calculated. In subgroup analyses involving patients with hepatitis B core antibody (HBcAb) testing, the AUC of AFP and DCP were also calculated and compared.
Serum levels of AFP and DCP were clearly increased in the NBNC HCC group relative to controls (p = 0.000 for both). The AUC for AFP, DCP and their combination (AFP+DCP) were 0.763 (95%CI: 0.712-0.814), 0.853 (95%CI: 0.811-0.894), and 0.867 (95%CI: 0.829-0.906), respectively. For HBcAb-positivity, the AUC of AFP and DCP were 0.7517 (95%CI: 0.6917-0.8116) and 0.8469 (95% CI: 0.7985-0.8963), respectively. For HBcAb-negativity, the AUC of AFP and DCP were 0.8083 (95%CI: 0.6993-0.9174) and 0.8740 (95%CI: 0.7901-0.9580), respectively.
A combination of AFP and DCP is useful for assisting the diagnosis of NBNC HCC before surgery. AFP and DCP showed better diagnostic accuracy for HBcAb-negativity compared with HBcAb-positivity in NBNC HCC patients.
确定甲胎蛋白（AFP）和异常凝血酶原（DCP）对非B、非C型肝细胞癌（NBNC HCC）患者的诊断价值。
观察性研究。
2016年6月至2019年6月，中国杭州浙江大学医学院附属第一医院。
对经组织学诊断为NBNC HCC的患者进行根治性切除术后纳入研究。测定血清AFP和DCP水平。绘制其受试者工作特征（ROC）曲线，并计算ROC曲线下面积（AUC）。在涉及乙肝核心抗体（HBcAb）检测患者的亚组分析中，也计算并比较了AFP和DCP的AUC。
与对照组相比，NBNC HCC组血清AFP和DCP水平明显升高（两者p = 0.000）。AFP、DCP及其联合检测（AFP + DCP）的AUC分别为0.763（95%CI：0.712 - 0.814）、0.853（95%CI：0.811 - 0.894）和0.867（95%CI：0.829 - 0.906）。对于HBcAb阳性患者，AFP和DCP的AUC分别为0.7517（95%CI：0.6917 - 0.8116）和0.8469（95%CI：0.7985 - 0.8963）。对于HBcAb阴性患者，AFP和DCP的AUC分别为0.8083（95%CI：0.6993 - 0.9174）和0.8740（95%CI：0.7901 - 0.9580）。
AFP和DCP联合检测有助于术前诊断NBNC HCC。在NBNC HCC患者中，与HBcAb阳性相比，AFP和DCP对HBcAb阴性患者显示出更好的诊断准确性。
