A simultaneous monitoring of Lens culinaris agglutinin A-reactive alpha-fetoprotein and des-gamma-carboxy prothrombin as an early diagnosis of hepatocellular carcinoma in the follow-up of cirrhotic patients.

Shimauchi, Yoshihiro; Tanaka, Masatoshi; Kuromatsu, Ryoko; Ogata, Rie; Tateishi, Yukio; Itano, Satoshi; Ono, Noriyuki; Yutani, Shigeru; Nagamatsu, Hiroaki; Matsugaki, Satoru; Yamasaki, Sayo; Tanikawa, Kyuichi; Sata, Michio

doi:10.3892/or.7.2.249

Cited by 40 publications

(39 citation statements)

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“…1, Table 1) [68][69][70][71][72][73][74][75][76][77][78][79][80][81][82][83][84]. Eleven studies included data on more than one tumor marker [70, 71, 73-77, 79-81, 83], and 4 of them provided sensitivity and specificity of a combination of two tumor markers [70,74,77,79]. As 8 studies provided sensitivity and specificity with more than one cutoff value [68, 70, Test for heterogeneity 4 mAU/ml chi-square = 5.44; df = 1; P = 0.20 40 mAU/ml chi-square = 2.58; df = 4; P =0.63 100 mAU/ml chi-square = 10.14; df = 6; P = 0.12 combined chi-square = 41.29; df = 15; P = 0.0003 Table 2.…”

Section: Resultsmentioning

confidence: 99%

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Diagnostic accuracy of tumor markers for hepatocellular carcinoma: a systematic review

et al. 2007

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Background and aims The role of alphafetoprotein (AFP) in the diagnosis and surveillance of hepatocellular carcinoma (HCC) is getting smaller owing to the advances in imaging modalities. The aims of this study were to assess the diagnostic accuracy of tumor markers in small HCC and to find the optimal cutoff value of each tumor marker for efficient surveillance. Methods Studies in all languages were identified by searching MEDLINE from 1982 to 2002. Studies were included when they showed sensitivity and specificity for HCCs 5 cm or smaller and recruited only patients with chronic hepatitis or liver cirrhosis as control. We assessed diagnostic odds ratios (DORs) for the evaluation of diagnostic accuracy of tumor markers and positive likelihood ratios (LRs+) to find the optimal cutoff value. DORs and LRs+ were combined according to the random effect model. The summary receiver operating characteristics (ROC) curve was also assessed. Results Seventeen articles on three tumor markers-AFP, des-gamma-carboxyprothrombin (DCP), and Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3)-were enrolled after full-text evaluation. AFP was inferior to DCP and AFP-L3 in both DOR (4.50 vs. 8.16 and 10.50) and area under the ROC curve (0.647 vs. 0.688 and 0.695). Optimal cutoff values that provide the best LR+ were 200 ng/ml for AFP, 40 mAU/ml for DCP, and 15% for AFP-L3. Conclusions Diagnostic accuracy of AFP in small HCC was substantially limited. Surveillance including other tumor markers with optimal cutoff value should be conducted to confirm the efficacy of the policy.

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Section: Resultsmentioning

confidence: 99%

“…AFP-L3 and DCP showed higher diagnostic accuracy than AFP (Table 4). We also plotted the combined sensitivity and specificity of AFP + DCP, AFP-L3 + DCP, and AFP + AFP-L3 provided in four studies [70,74,77,79].…”

Section: Resultsmentioning

confidence: 99%

Diagnostic accuracy of tumor markers for hepatocellular carcinoma: a systematic review

et al. 2007

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“…Sassa et al [27] reported that it was 44.3% for ≤ 2 cm. An assay that employs higher DCP diagnostic sensitivity has been introduced [25,26] , but the diagnostic sensitivity for small hepatocellular carcinoma still remains at about 50% [27][28][29][30] . Thus, most reports on biological properties of DCP positive hepatic carcinoma are based on more advanced diseases [7] .…”

Section: Discussionmentioning

confidence: 99%

“…However, the rate of detectable serum DCP levels in patients with small hepatocellular carcinoma is low [19][20][21][22][23][24] . Although methods have been improved [25,26] , sensitivity is still at about 50% for most small cell carcinoma [27][28][29][30] . Thus, almost all reports on the biological nature of DCP and its prognostic value are based on analyses of patients with larger or more advanced tumors with various degrees of hepatic functional reserve.…”

Section: Introductionmentioning

confidence: 99%

Des-gamma-carboxy prothrombin as an important prognostic indicator in patients with small hepatocellular carcinoma

Hakamada

Kimura²,

Miura³

et al. 2008

WJG

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tumor recurrence. Because many patients with a high preoperative DCP level develop extrahepatic recurrence, it is necessary to screen the whole body. INTRODUCTIONDes-gamma-carboxy prothrombin (DCP) is a tumor marker specific for hepatocellular carcinoma [1] . It is believed that the elevation of the serum DCP level correlates with the presence of vascular invasion or intrahepatic metastases [2][3][4][5][6][7][8] . Furthermore, DCP has been reported to be an independent prognostic factor for recurrence and survival after hepatic resection [4,[9][10][11][12][13] , liver transplantation [6,14] , ablation treatment [15][16][17] , and transarterial chemoembolization (TAE) treatment [18] . However, the rate of detectable serum DCP levels in patients with small hepatocellular carcinoma is low [19][20][21][22][23][24] . Although methods have been improved [25,26] , sensitivity is still at about 50% for most small cell carcinoma [27][28][29][30] . Thus, almost all reports on the biological nature of DCP and its prognostic value are based on analyses of patients with larger or more advanced tumors with various degrees of hepatic functional reserve. Reports on the relevance of preoperative DCP level as a prognostic marker in small hepatocellular carcinoma patients are rare.This study thus aimed analysing the predictive value of preoperative serum DCP level on tumor recurrence and prognosis, particularly in hepatocellular carcinoma patients who had undergone liver resection and who met the criteria for small hepatocellular carcinoma [31] , i.e. a single Abstract AIM: To clarify the effect of a high des-gamma-carboxy prothrombin (DCP) level on the invasiveness and prognosis of small hepatocellular carcinoma. METHODS:Among 142 consecutive patients with known DCP levels, who underwent hepatectomy because of hepatocellular carcinoma, 85 patients met the criteria for small hepatocellular carcinoma, i.e. one ≤ 5 cm sized single tumor or no more than three ≤ 3 cm sized tumors. RESULTS:The overall survival rate of the 142 patients was 92.1% for 1 year, 69.6% for 3 years, and 56.9% for 5 years. Multivariate analysis showed that microscopic vascular invasion (P = 0.03) and serum DCP ≥ 400 mAU/mL (P = 0.02) were independent prognostic factors. In the group of patients who met the criteria for small hepatocellular carcinoma, DCP ≥ 400 mAU/mL was found to be an independent prognostic factor for recurrence-free (P = 0.02) and overall survival (P = 0.0005). In patients who did not meet the criteria, the presence of vascular invasion was an independent factor for recurrence-free (P = 0.02) and overall survivals (P = 0.01). In 75% of patients with small hepatocellular carcinoma and high DCP levels, recurrence occurred extrahepatically. CONCLUSION:For small hepatocellular carcinoma, a high preoperative DCP level appears indicative for

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“…45 Several prospective cohort studies of patients with cirrhosis but without HCC have been performed to determine the performance of DCP. [46][47][48][49] The sensitivities for detecting HCC ranged from 23% to 57% for DCP compared to 14% to 71% for AFP. In the largest study with DCP, 734 patients with cirrhosis were followed for a mean of 13 months (range, 7-17), during which HCC was detected in 29 patients.…”

Section: S C R E E N I N G F O R H E P a T O C E L L U L A R C A R C mentioning

confidence: 99%

Screening for hepatocellular carcinoma

2000

Cleveland Clinic Journal of Medicine

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A simultaneous monitoring of Lens culinaris agglutinin A-reactive alpha-fetoprotein and des-gamma-carboxy prothrombin as an early diagnosis of hepatocellular carcinoma in the follow-up of cirrhotic patients.

Cited by 40 publications

References 0 publications

Diagnostic accuracy of tumor markers for hepatocellular carcinoma: a systematic review

Diagnostic accuracy of tumor markers for hepatocellular carcinoma: a systematic review

Des-gamma-carboxy prothrombin as an important prognostic indicator in patients with small hepatocellular carcinoma

Screening for hepatocellular carcinoma

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