Department of Infection and Hepatology, Hwa Mei Hospital, University of Chinese Academy of Sciences, Ningbo, Zhejiang, China.
Research and Development Division, Oriomics Biotech, Hangzhou, Zhejiang, China.
J Clin Lab Anal. 2022 Apr;36(4):e24296. doi: 10.1002/jcla.24296. Epub 2022 Feb 26.
Previous studies have developed some blood-based biomarker algorithms such as the Doylestown algorithm and aMAP score to improve the detection of Hepatocellular carcinoma (HCC). However, no one has studied the application of the Doylestown algorithm in the Chinese. Meanwhile, which of these two screening models is more suitable for people with liver cirrhosis remains to be investigated.
In this study, HCC surveillance was performed by radiographic imaging and testing for tumor markers every 6 months from August 21, 2018, to January 12, 2021. We conducted a retrospective study of 742 liver cirrhosis patients, and among them, 20 developed HCC during follow-up. Samples from these patients at three follow-up time points were tested to evaluate alpha-fetoprotein (AFP), the Doylestown algorithm, and aMAP score.
Overall, 521 liver cirrhosis patients underwent semiannual longitudinal follow-up three times. Five patients were diagnosed with HCC within 0-6 months of the third follow-up. We found that for these liver cirrhosis patients, the Doylestown algorithm had the highest accuracy for HCC detection, with areas under the receiver operating characteristic curve (AUCs) of 0.763, 0.801, and 0.867 for follow-ups 1-3, respectively. Compared with AFP at 20 ng/ml, the Doylestown algorithm increased biomarker performance by 7.4%, 21%, and 13% for follow-ups 1-3, respectively.
Our findings show that the Doylestown algorithm performance appeared to be optimal for HCC early screening in the Chinese cirrhotic population when compared with the aMAP score and AFP at 20 ng/ml.
先前的研究已经开发出一些基于血液的生物标志物算法，如 Doylestown 算法和 aMAP 评分，以提高肝细胞癌（HCC）的检测率。然而，还没有人研究过 Doylestown 算法在中国人中的应用。同时，这两种筛查模型中哪一种更适合肝硬化患者仍有待研究。
本研究通过影像学检查和肿瘤标志物检测，对 2018 年 8 月 21 日至 2021 年 1 月 12 日期间的 742 例肝硬化患者进行 HCC 监测。我们对 742 例肝硬化患者进行了回顾性研究，其中 20 例在随访期间发生 HCC。对这些患者的三个随访时间点的样本进行检测，以评估甲胎蛋白（AFP）、Doylestown 算法和 aMAP 评分。
共有 521 例肝硬化患者进行了三次半年的纵向随访。有 5 例患者在第三次随访后的 0-6 个月内被诊断为 HCC。我们发现，对于这些肝硬化患者，Doylestown 算法在 HCC 检测方面的准确性最高，其在 1-3 次随访时的受试者工作特征曲线（ROC）下面积（AUCs）分别为 0.763、0.801 和 0.867。与 AFP 为 20ng/ml 相比，Doylestown 算法在 1-3 次随访时分别将生物标志物性能提高了 7.4%、21%和 13%。
与 AFP 为 20ng/ml 相比，我们的研究结果表明，Doylestown 算法在检测中国肝硬化人群的 HCC 早期方面的表现似乎优于 aMAP 评分和 AFP 为 20ng/ml。
