Clinical validation of combined serological biomarkers for improved hepatocellular carcinoma diagnosis in 961 patients
Clinical validation of combined serological biomarkers for improved hepatocellular carcinoma diagnosis in 961 patients
复制标题
DOI：
10.1016/j.cca.2007.05.014
复制
发表时间：
2007-08-01
影响因子：
5
通讯作者：
Antonaci, Salvatore
中科院分区：
文献类型：
--
作者：
Giannelli, Gianluigi;Fransvea, Emilia;Antonaci, Salvatore
背景资料：甲胎蛋白（AFP），目前可用于检测肝细胞癌（HCC）的唯一血清学标志物，是不令人满意的，因为它的敏感性差，因为是最近提出的其他标志物。因此，迫切需要新的生物标志物。鳞状细胞癌抗原（SCCA），一种丝氨酸蛋白酶抑制剂，生理上存在于皮肤中，最近已被报道存在于HCC患者，也免疫复合物（IC）形式的SCCA和AFP：SCCAIC和AFPICs.Methods：以确定新的血清生物标志物的诊断准确性诊断HCC的一个快速，简单的ELISA试验应用于961例患者。灵敏度和特异性确定为每个标志物和所有的标志物结合在检测较小和较大的HCC与肝cirrhosis.Results：在较小的HCC，受试者的工作特性分析得出以下AUC：AFP 0.714（CI 95%0.679 -0.748），AFPIC 0.691（CI 195%0.655 -0.748），SCCA 0.703（CI 195%0.667 -0.736），SCCAIC 0.694（CI 95%0.659 -0.728）。SCCA与大小呈负相关。联合使用AFPIC、SCCA和SCCAIC在显示低AFP水平的患者中（
Background: Alpha-fetoprotein (AFP), the only serological marker currently available for the detection of hepatocellular carcinoma (HCC), is unsatisfactory because of its poor sensitivity, as are other recently proposed markers. Therefore new biomarkers are badly needed. Squamous cell carcinoma antigen (SCCA), a serine protease inhibitor physiologically present in the skin, has recently been reported to be present in HCC patients, as also the immunocomplexed (IC) forms of SCCA and AFP: SCCAIC and AFPIC, respectively.Methods: To determine the diagnostic accuracy of new serum biomarkers for the diagnosis of HCC a rapid, simple ELISA test was applied in 961 patients. Sensitivity and specificity were determined for each marker and for all the markers combined in detecting smaller and larger HCC versus liver cirrhosis.Results: In smaller HCC, receiver operating characteristics analysis yielded the following AUC: AFP 0.714 (CI 95% 0.679-0.748), AFPIC 0.691 (C195% 0.655-0.748), SCCA 0.703 (C195% 0.667-0.736), SCCAIC 0.694 (CI 95% 0.659-0.728). SCCA was inversely correlated with size. The combined use of AFPIC, SCCA and SCCAIC in patients displaying low levels of AFP (