Department of Hepatobiliary, Liver Cancer Research Center for Prevention and Therapy.
Department of Tumor Cell Biology.
Cancer Biol Med. 2021 Feb 15;18(1):256-270. doi: 10.20892/j.issn.2095-3941.2020.0207.
Hepatocellular carcinoma (HCC) is a lethal global disease that requires an accurate diagnosis. We assessed the potential of 5 serum biomarkers (AFP, AFU, GGT-II, GPC3, and HGF) in the diagnosis of HCC.
In this retrospective study, we measured the serum levels of each biomarker using ELISAs in 921 participants, including 298 patients with HCC, 154 patients with chronic hepatitis (CH), 122 patients with liver cirrhosis (LC), and 347 healthy controls from 3 hospitals. Patients negative for hepatitis B surface antigen and hepatitis C antibody (called "NBNC-HCC") and patients positive for the above indices (called "HBV-HCC and HCV-HCC") were enrolled. The selected diagnostic model was constructed using a training cohort ( = 468), and a validation cohort ( = 453) was used to validate our results. Receiver operating characteristic analysis was used to evaluate the diagnostic accuracy.
The α-L-fucosidase (AFU)/α-fetoprotein (AFP) combination was best able to distinguish NBNC-HCC [area under the curve: 0.986 (95% confidence interval: 0.958-0.997), sensitivity: 92.6%, specificity: 98.9%] from healthy controls in the test cohort. For screening populations at risk of developing HCC (CH and LC), the AFP/AFU combination improved the diagnostic specificity for early-stage HCC [area under the curve: 0.776 (0.712-0.831), sensitivity: 52.5%, specificity: 91.6% in the test group]. In all-stage HBV-HCC and HCV-HCC, AFU was also the best candidate biomarker combined with AFP [area under the curve: 0.835 (0.784-0.877), sensitivity 69.1%, specificity: 87.4% in the test group]. All results were verified in the validation group.
The AFP/AFU combination could be used to identify NBNC-HCC from healthy controls and hepatitis-related HCC from at-risk patients.
肝细胞癌（HCC）是一种致命的全球性疾病，需要准确的诊断。我们评估了 5 种血清标志物（AFP、AFU、GGT-II、GPC3 和 HGF）在 HCC 诊断中的潜力。
在这项回顾性研究中，我们使用 ELISA 测量了来自 3 家医院的 921 名参与者的每种生物标志物的血清水平，包括 298 名 HCC 患者、154 名慢性肝炎（CH）患者、122 名肝硬化（LC）患者和 347 名健康对照者。未感染乙型肝炎表面抗原和丙型肝炎抗体的患者（称为“非乙型肝炎病毒/丙型肝炎病毒相关性 HCC（NBNC-HCC）”）和感染上述指标的患者（称为“乙型肝炎病毒相关性 HCC 和丙型肝炎病毒相关性 HCC（HBV-HCC 和 HCV-HCC）”）被纳入研究。使用训练队列（n=468）构建了选定的诊断模型，并使用验证队列（n=453）验证了我们的结果。采用受试者工作特征分析评估诊断准确性。
在测试队列中，α-L-岩藻糖苷酶（AFU）/甲胎蛋白（AFP）联合检测能够最佳地区分 NBNC-HCC[曲线下面积：0.986（95%置信区间：0.958-0.997），敏感性：92.6%，特异性：98.9%]与健康对照组。对于有 HCC 发病风险的人群（CH 和 LC），AFP/AFU 联合检测提高了早期 HCC 的诊断特异性[曲线下面积：0.776（0.712-0.831），敏感性：52.5%，特异性：91.6%，在测试组中]。在所有阶段的 HBV-HCC 和 HCV-HCC 中，AFU 也是与 AFP 联合检测的最佳候选生物标志物[曲线下面积：0.835（0.784-0.877），敏感性：69.1%，特异性：87.4%，在测试组中]。所有结果在验证组中均得到验证。
AFP/AFU 联合检测可用于从健康对照者中识别 NBNC-HCC，从高危患者中识别与肝炎相关的 HCC。
