Diagnostic Value of Serum Biomarkers in Combined Hepatocelluar-Cholangiocarcinoma.

OBJECTIVE

To explore the value of des-gamma-carboxyprothrombin (DCP), alpha-fetoprotein (AFP) and carbohydrate antigen-199 (CA-199) for diagnosis of combined hepatocellular-cholangiocarcinoma (cHCC-CC).

STUDY DESIGN

Observational correlational study design.

PLACE AND DURATION OF STUDY

The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China, from June 2016 to June 2019.

METHODOLOGY

Patients with cHCC-CC (n = 26) diagnosed by histological examination and immunohistochemical staining were matched as 1:2 to controls (n = 52) based on age (±2 years), gender (male or female), liver texture (cirrhosis or not) and ethnicity. Serum DCP, AFP and CA-199 levels were determined and Youden indices were calculated. Receiver operating characteristic (ROC) curves were generated and areas under the receiver operating characteristic curve (AUC) were calculated.

RESULTS

The levels of DCP, AFP and CA-199 were clearly elevated in the cHCC-CC group relative to controls with p-values of <0.001, <0.001 and 0.001, respectively. Youden index values for DCP, AFP, CA-199, and their combination (DCP+AFP+CA-199) were 0.5, 0.423, 0.173 and 0.673, respectively. The AUC curve values for DCP, AFP, CA-199 and their combination (DCP+AFP+CA-199) were 0.759 (95% CI: 0.624 - 0.894), 0.826 (95% CI: 0.720 - 0.933), 0.727 (95% CI: 0.613 - 0.841) and 0.862 (95% CI: 0.755 - 0.968), respectively.

CONCLUSION

DCP, AFP and CA-199 have diagnostic value for cHCC-CC, and the combination of DCP, AFP and CA-199 is useful for assisting diagnosis before histological examination. Clinicians should be alert for cHCC-CC when DCP, AFP, or CA-199 levels are abnormal.