Complements as new diagnostic tools of hepatocellular carcinoma in cirrhotic patients
1Department of Internal Medicine, Kaohsiung Medical College, Taiwan, Republic of China.
Insights
Serum complement levels, including C3, C4, and C3 proactivator (C3PA), show promise for detecting hepatocellular carcinoma (HCC) in liver cirrhosis (LC) patients. Combining these with alpha-fetoprotein significantly improved diagnostic accuracy.
Area of Science:
- Biochemistry
- Oncology
- Immunology
Background:
- Hepatocellular carcinoma (HCC) is a significant global health concern, often developing in patients with underlying liver cirrhosis (LC).
- Early and accurate detection of HCC in LC patients is crucial for effective management and improved patient outcomes.
- Current diagnostic methods may have limitations, necessitating the exploration of novel biomarkers.
Purpose of the Study:
- To prospectively evaluate the diagnostic power of serum complements C3, C4, and C3 proactivator (C3PA) for detecting HCC in patients with LC.
- To establish optimal cutoff values for these complements based on a retrospective analysis.
- To assess the combined diagnostic utility of these complements with alpha-fetoprotein (AFP) for HCC detection.
Main Methods:
- Prospective study involving 63 patients with LC (36 with HCC).
- Retrospective analysis of 17 LC and 20 HCC patients to determine optimal complement cutoff values (C3: 75 mg/dl, C4: 16 mg/dl, C3PA: 18 mg/dl).
- Calculation of positive predictive values, negative predictive values, and accuracies for individual complements and their combination with AFP.
Main Results:
- Individual complement accuracies: C3 (87.3%), C4 (87.3%), C3PA (70.9%).
- C4 demonstrated the highest positive predictive value (93.8%), while C3PA had the highest negative predictive value (90.9%).
- Combining C3, C4, and AFP achieved a significantly higher accuracy of 93.7% for HCC detection.
Conclusions:
- Serum complement levels (C3, C4, C3PA) hold diagnostic potential for screening HCC in LC patients.
- The combination of C3, C4, and AFP offers a highly accurate diagnostic strategy for HCC in this population.
- Complement testing could serve as a valuable tool for HCC screening and post-therapy follow-up in LC patients.
Abstract:
Serum complements, C3, C4, and C3 proactivator (C3PA), were evaluated prospectively for their diagnostic power in detecting hepatocellular carcinoma (HCC) in patients with liver cirrhosis (LC). Sixty-three LC patients, including 36 LC with HCC patients, were recruited for this study during the period from March to November 1986. The cutoff values of the complements were set according to retrospective study including 17 LC patients and 20 HCC patients. The values with highest accuracy, 75 mg/dl C3, 16 mg/dl C4, and 18 mg/dl C3PA, were selected. Based on these data, the positive predictive values, negative predictive values, and the accuracies of complements were as follows: C3, 88.9%, 85.2%, and 87.3%; C4, 93.8%, 80.6%, and 87.3%; and C3PA, 66.7%, 90.9%, and 70.9%, respectively. The accuracy elevated to 93.7% when C3, C4, and alpha-fetoprotein were combined as the diagnostic criteria. This study supports the use of complement testing as a new diagnostic tool for HCC screening in LC patients and for follow-up evaluation in posttherapy patients of LC with HCC.
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