Nguyen Hoang Bac, Le Xuan-Thao Thi, Nguyen Huy Huu, Vo Thanh Thanh, Le Minh Khoi, Nguyen Ngan Trung, Do-Nguyen Thien Minh, Truong-Nguyen Cong Minh, Nguyen Bang-Suong Thi
Faculty of Medicine, University of Medicine and Pharmacy, Ho Chi Minh City, Viet Nam; University Medical Center, Ho Chi Minh City, Viet Nam.
Cancer Inform. 2022 May 20;21:11769351221100730. doi: 10.1177/11769351221100730. eCollection 2022.
Diagnosis of hepatocellular carcinoma (HCC) in early-stage, to give an effective treatment option and improve quality of life for cancer patients, is an important medical mission globally. Combination of AFP with some biomarkers may be more supportive in both diagnosis and screening of HCC, but the range value of these markers can be applied as daily markers were unclearly. In some studies, human telomerase reverse transcriptase (hTERT mRNA) was reported as an advantage marker to diagnose cancer. The present study identified serum of 340 patients that were infected chronic hepatitis B virus or hepatitis C virus and divided in 2 groups including Hepatocellular carcinoma (HCC) and liver cirrhosis (LC) to measure their values of hTERT mRNA, AFP, AFP-L3%, and DCP, as well as combination of them. As a result, the concentration of hTERT mRNA, AFP, AFP-L3%, and DCP in HCC groups were significantly higher than that in LC group ( < .01). For detecting HCC, hTERT mRNA had sensitivity of 88% and specificity of 96% (at the cutoff value of 31.5 copies/mL), AFP sensitivity of 73% and specificity of 92% (at the cutoff value of 5.1 ng/mL), AFP-L3% sensitivity of 69% and specificity of 90% (at the cutoff value of 1.05%), DCP sensitivity of 82% and specificity of 92% (at the cutoff value of 29.01 mAU/mL). The largest area under the curve (AUC) of combination hTERT mRNA with DCP was 0.932 (sensitivity of 98.2% and specificity of 88.2%). New combination of DCP with hTERT mRNA gave a useful choice for screening of HCC in chronic HBV or HCV patients associated liver cirrhosis.
早期诊断肝细胞癌（HCC），为癌症患者提供有效的治疗选择并改善其生活质量，是全球一项重要的医疗任务。甲胎蛋白（AFP）与某些生物标志物联合使用可能在HCC的诊断和筛查中更具辅助作用，但这些标志物的正常范围值能否作为日常标志物并不明确。在一些研究中，人端粒酶逆转录酶（hTERT mRNA）被报道为诊断癌症的优势标志物。本研究纳入了340例慢性乙型肝炎病毒或丙型肝炎病毒感染者，将其分为肝细胞癌（HCC）和肝硬化（LC）两组，检测他们的hTERT mRNA、AFP、AFP-L3%和异常凝血酶原（DCP）值，以及它们的联合检测结果。结果显示，HCC组的hTERT mRNA、AFP、AFP-L3%和DCP浓度显著高于LC组（P＜0.01）。对于HCC检测，hTERT mRNA的灵敏度为88%，特异性为96%（临界值为31.5拷贝/mL）；AFP灵敏度为73%，特异性为92%（临界值为5.1 ng/mL）；AFP-L3%灵敏度为69%，特异性为90%（临界值为1.05%）；DCP灵敏度为82%，特异性为92%（临界值为29.01 mAU/mL）。hTERT mRNA与DCP联合检测的曲线下面积（AUC）最大，为0.932（灵敏度为98.2%，特异性为88.2%）。DCP与hTERT mRNA的新联合检测为慢性HBV或HCV相关肝硬化患者的HCC筛查提供了一种有用的选择。
