Affiliations: [a] Department of Clinical Laboratory, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China | [b] Key Laboratory of Medical Laboratory Diagnostics of the Education Ministry, College of Laboratory Medicine, Chongqing Medical University, Chongqing, China
Correspondence:
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Corresponding author: Yunsheng Zhao, Department of Clinical Laboratory, The First Hospital of Qinhuangdao, Qinhuangdao 066000, Hebei, China. Tel.: +86 0335 5908421; Fax: +86 0335 5908359; E-mail:zhaoyunshengsh@163.com
Abstract:
BACKGROUND: The most practical serum biomarker AFP is negative in
80% patients with small tumor in the early stage of primary
hepatocellular carcinoma (PHC). OBJECTIVE: To investigate significance of combined tests of serum
golgi glycoprotein 73 (GP73), lens culinaris agglutinin-reactive
alpha-fetoprotein (AFP-L3), glypican 3 (GPC3), des-gamma-carboxy prothrombin
(DCP), CA199, ferritin (FER) and carcinoembryonic antigen (CEA) in diagnosis
of small PHC with negative AFP. METHODS: A total of 50 cases of small PHC, 60 cases of non-PHC
digestive system disorders and 40 cases of healthy controls were collected.
Serum GP73, GPC3 and DCP were analyzed by enzyme-1inked immunosorbent assay.
AFP-L3 was separated by microspincolumn; the levels of CA199, FER, CEA,
AFP-L3 and total AFP were quantified by electrochemiluminescence
immunoassays; percentage of AFP-L3 to total AFP was calculated. RESULTS: Levels of those biomarkers except FER were all
significantly different among three groups (P < 0.01). Positive detection rates
of seven biomarkers in PHC were higher than other groups (P < 0.01). In
individual detection, the highest sensitivity, accuracy rate and area under
ROC curve were 72.0%, 86.7% and 0.826 by GP73 and the highest
specificity was 98.0% by GPC3. In combined detection with those seven
biomarkers, the sensitivity, specificity, accuracy rate and area under ROC
curve were 82.0%, 95.0%, 90.1% and 0.884. CONCLUSIONS: GP73 and AFP-L3 are superior biomarkers to aid the
diagnosis of small PHC with negative AFP. The combined detection of
biomarkers improved the diagnostic accuracy.
