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Evaluation of the Combined Application of AFP, AFP-L3%, and DCP for Hepatocellular Carcinoma Diagnosis: A
Xueying Wang1,2, Yangyu Zhang1, Na Yang1
1Division of Clinical Research, First Hospital of Jilin University, Changchun, Jilin Province, China.
Abstract:
The role of α-fetoprotein (AFP) in the surveillance and diagnosis of hepatocellular carcinoma (HCC) has been questioned in recent years due to its low sensitivity and specificity. In addition to AFP, several new serum biomarkers, such as lens culinaris agglutinin-reactive fraction of AFP (AFP-L3) and des-gamma-carboxy prothrombin (DCP), have also been identified as useful HCC serological markers. However, the exact diagnostic value of the combinations of these biomarkers for detecting HCC in patients with liver disease remains unclear. Thus, we performed the current meta-analysis to assess performance of AFP+AFP-L3%+DCP for diagnosing HCC. Studies were systematically searched in PubMed, Embase, the Cochrane Library, CNKI, and WanFang Data databases. After full-text evaluation, 13 studies from 11 articles focusing on the combination of the three serum biomarkers for HCC detection were enrolled. Random-effects models were used due to the presence of heterogeneity. The pooled sensitivity and specificity for AFP+AFP-L3%+DCP were 88% and 79%, respectively. The area under the summary receiver operating characteristic (sROC) curve was 0.91, and the diagnostic odds ratio (DOR) was 28.33 (95% CI 16.78-47.83). Subgroup analysis showed that the pooled sensitivity and specificity of AFP+AFP-L3%+DCP in the diagnosis of HCC versus cirrhosis patients were 0.81 and 0.82, respectively. In conclusion, the combination of AFP, AFP-L3%, and DCP may prove to be useful in the diagnosis and screening of HCC.
Insights
The combination of alpha-fetoprotein (AFP), AFP-L3%, and des-gamma-carboxy prothrombin (DCP) shows promise for diagnosing hepatocellular carcinoma (HCC). This biomarker panel offers improved sensitivity and specificity for HCC detection in patients with liver disease.
Area of Science:
- Hepatology
- Oncology
- Biomarker Discovery
Background:
- Alpha-fetoprotein (AFP) has limitations in diagnosing hepatocellular carcinoma (HCC) due to low sensitivity and specificity.
- Newer serum biomarkers, including AFP-L3% and des-gamma-carboxy prothrombin (DCP), show potential for HCC detection.
- The combined diagnostic utility of these biomarkers for HCC in liver disease patients requires further clarification.
Purpose of the Study:
- To evaluate the diagnostic performance of a combined biomarker panel (AFP, AFP-L3%, DCP) for hepatocellular carcinoma (HCC).
- To assess the accuracy of this combination in detecting HCC, particularly in patients with underlying liver conditions.
Main Methods:
- A systematic meta-analysis was conducted, searching major scientific databases (PubMed, Embase, Cochrane Library, CNKI, WanFang Data).
- 13 studies involving 11 articles were included, focusing on the concurrent use of AFP, AFP-L3%, and DCP for HCC diagnosis.
- Random-effects models were employed to analyze the pooled data, accounting for study heterogeneity.
Main Results:
- The pooled sensitivity for the AFP+AFP-L3%+DCP panel was 88%, with a specificity of 79%.
- The area under the summary receiver operating characteristic (sROC) curve was 0.91, indicating strong diagnostic accuracy.
- Diagnostic odds ratio (DOR) was 28.33, and subgroup analysis showed 81% sensitivity and 82% specificity for HCC versus cirrhosis.
Conclusions:
- The combined assessment of AFP, AFP-L3%, and DCP demonstrates significant potential as a diagnostic and screening tool for hepatocellular carcinoma (HCC).
- This multi-biomarker approach may overcome the limitations of individual markers, offering improved accuracy in HCC detection.
- Further validation in diverse clinical settings is warranted to fully establish its role in HCC management.
