BACKGROUND: Alpha-fetoprotein (AFP), lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), des-γ-carboxy prothrombin (DCP), and Golgi protein-73 (GP73) have been used or proposed as tumor markers for hepatocellular carcinoma (HCC). METHODS: They were measured in 96 patients undergoing hepatectomy for HCC to investigate their treatment response and association with variables linked with tumor invasiveness and/or prognosis. Values at 1 month post-surgery in the 77 patients without recurrence within 6 postoperative months were adopted as those after surgery. RESULTS: GP73 levels did not change after hepatectomy, but levels of other markers decreased and areas under receiver operating characteristic curves (95% CI) were: 0.64 (0.56-0.72), 0.63 (0.55-0.71), 0.79 (0.73-0.86), and 0.63 (0.55-0.71) for AFP, AFP-L3, DCP, and combination of AFP and AFP-L3, respectively. Cutoff points giving specificities of 96.1% (sensitivities at these points) were: 124 ng/mL (28.1%), 10% (21.9%), and 60 mAU/mL (52.1%), for AFP, AFP-L3, and DCP, respectively. The combination of AFP and AFP-L3 provided a sensitivity of 26.0% at a specificity of 96.1%. The increased DCP value was, or tended to be, associated with a larger tumor, vascular invasion, intrahepatic metastases, and a lower grade of tumor cell differentiation. Although similar associations were found between AFP and vascular invasion as well as a lower grade of tumor cell differentiation, no such relationship was found with AFP-L3. CONCLUSIONS: DCP is a more effective tumor marker than AFP and AFP-L3. AFP-L3 showed comparable accuracy to AFP but no benefit was found in their combination. GP73 did not play a significant role in this context. Indices of tumor invasiveness were most closely associated with DCP.
BACKGROUND: Alpha-fetoprotein (AFP), lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), des-γ-carboxy prothrombin (DCP), and Golgi protein-73 (GP73) have been used or proposed as tumor markers for hepatocellular carcinoma (HCC). METHODS: They were measured in 96 patients undergoing hepatectomy for HCC to investigate their treatment response and association with variables linked with tumor invasiveness and/or prognosis. Values at 1 month post-surgery in the 77 patients without recurrence within 6 postoperative months were adopted as those after surgery. RESULTS:GP73 levels did not change after hepatectomy, but levels of other markers decreased and areas under receiver operating characteristic curves (95% CI) were: 0.64 (0.56-0.72), 0.63 (0.55-0.71), 0.79 (0.73-0.86), and 0.63 (0.55-0.71) for AFP, AFP-L3, DCP, and combination of AFP and AFP-L3, respectively. Cutoff points giving specificities of 96.1% (sensitivities at these points) were: 124 ng/mL (28.1%), 10% (21.9%), and 60 mAU/mL (52.1%), for AFP, AFP-L3, and DCP, respectively. The combination of AFP and AFP-L3 provided a sensitivity of 26.0% at a specificity of 96.1%. The increased DCP value was, or tended to be, associated with a larger tumor, vascular invasion, intrahepatic metastases, and a lower grade of tumor cell differentiation. Although similar associations were found between AFP and vascular invasion as well as a lower grade of tumor cell differentiation, no such relationship was found with AFP-L3. CONCLUSIONS: DCP is a more effective tumor marker than AFP and AFP-L3. AFP-L3 showed comparable accuracy to AFP but no benefit was found in their combination. GP73 did not play a significant role in this context. Indices of tumor invasiveness were most closely associated with DCP.
Authors: Jorge A Marrero; Patrick R Romano; Olga Nikolaeva; Laura Steel; Anand Mehta; Claus J Fimmel; Mary Ann Comunale; Anthony D'Amelio; Anna S Lok; Timothy M Block Journal: J Hepatol Date: 2005-06-28 Impact factor: 25.083
Authors: Jorge A Marrero; Ziding Feng; Yinghui Wang; Mindie H Nguyen; Alex S Befeler; Lewis R Roberts; K Rajender Reddy; Denise Harnois; Josep M Llovet; Daniel Normolle; Jackie Dalhgren; David Chia; Anna S Lok; Paul D Wagner; Sudhir Srivastava; Myron Schwartz Journal: Gastroenterology Date: 2009-04-09 Impact factor: 22.682
Authors: Yuxin Guo; Darren W Chua; Ye-Xin Koh; Ser-Yee Lee; Peng-Chung Cheow; Juinn-Huar Kam; Jin-Yao Teo; Pierce K Chow; Alexander Y Chung; London L Ooi; Chung-Yip Chan; Brian K P Goh Journal: World J Surg Date: 2019-10 Impact factor: 3.352