Des-gamma-carboxy prothrombin and alpha-fetoprotein as biomarkers for the early detection of hepatocellular carcinoma.
Des-gamma-carboxy prothrombin and alpha-fetoprotein as biomarkers for the early detection of hepatocellular carcinoma.
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DOI：
10.1053/j.gastro.2009.10.031
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发表时间：
2010-02
期刊：
影响因子：
29.4
通讯作者：
HALT-C Trial Group
中科院分区：
文献类型：
--
作者：
Lok AS;Sterling RK;Everhart JE;Wright EC;Hoefs JC;Di Bisceglie AM;Morgan TR;Kim HY;Lee WM;Bonkovsky HL;Dienstag JL;HALT-C Trial Group
由于诊断较晚，肝细胞癌（HCC）患者的预后仍然很差。本研究的目的是比较甲胎蛋白（AFP）和去- γ -羧基凝血酶原（DCP）在HCC早期诊断中的准确性。在丙型肝炎抗病毒长期治疗肝硬化（HALT-C）试验中随机分配的1031例患者中，对39例HCC患者（24例早期）和77例匹配对照进行了巢式病例对照研究，比较AFP和DCP的疗效。检测前12个月（- 12个月）至HCC诊断时（第0个月）的血清。第0个月DCP的敏感性和特异性在40 mAU/mL的临界值下分别为74%和86%，在150 mAU/mL的临界值下分别为43%和100%。在第0个月时，AFP的敏感性和特异性在20 ng/mL时分别为61%和81%，在200 ng/mL时分别为22%和100%。在- 12个月时，DCP的敏感性和特异性分别为43%和94%，AFP的敏感性和特异性分别为47%和75%。联合使用这两种标志物可使敏感性在第0个月和第12个月分别提高到91%和73%，但特异性分别下降到74%和71%。14例早期HCC的诊断是通过超声监测，5例AFP翻倍，5例联合检查。早期HCC的检测需要生物标志物来补充超声，但DCP和AFP都不是最佳选择。
The outcome of patients with hepatocellular carcinoma (HCC) remains poor because of late diagnosis. The aim of this study was to compare the accuracy of alpha fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) in the early diagnosis of HCC. Among 1031 patients randomized in the Hepatitis C Antiviral Long-Term Treatment against Cirrhosis (HALT-C) Trial, a nested case-control study of 39 HCC cases (24 early stage) and 77 matched controls was conducted to compare the performance of AFP and DCP. Testing was performed on sera from 12 months prior (month −12) to the time of HCC diagnosis (month 0). The sensitivity and specificity of DCP at month 0 was 74% and 86% at a cutoff of 40 mAU/mL and 43% and 100% at a cutoff of 150 mAU/mL. The sensitivity and specificity of AFP at month 0 was 61% and 81% at a cutoff of 20 ng/mL and 22% and 100% at a cutoff of 200 ng/mL. At month −12, the sensitivity and specificity at the low cutoff was 43% and 94% for DCP and 47% and 75% for AFP. Combining both markers increased the sensitivity to 91% at month 0 and 73% at month 12 but the specificity decreased to 74% and 71%. Diagnosis of early HCC was triggered by surveillance ultrasound in 14, doubling of AFP in 5 and combination of tests in 5 patients. Biomarkers are needed to complement ultrasound in the detection of early HCC but neither DCP nor AFP is optimal.
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影响因子：
5.1
作者：
Marrero, Jorge A
通讯作者：
Marrero, Jorge A
影响因子：
13.5
作者：
Marrero, JA;Su, GL;Lok, AS
通讯作者：
Lok, AS
DOI：
10.1016/j.cct.2004.08.003
发表时间：
2004-10-01
期刊：
CONTROLLED CLINICAL TRIALS
影响因子：
--
作者：
Lee, WM;Dienstag, JL;Everhart, JE
通讯作者：
Everhart, JE
影响因子：
9.8
作者：
Chalasani, N;Horlander, JC;Lumeng, L
通讯作者：
Lumeng, L
影响因子：
13.5
作者：
OKA, H;TAMORI, A;YAMAMOTO, S
通讯作者：
YAMAMOTO, S