HCC-ART score, a simple, highly sensitive and specific test for early diagnosis of hepatocellular carcinoma: a large-scale, multicentre study

Abstract

Background:A simple scoring system is needed to discriminate HCC from patients with chronic liver diseases (CLD). The simplest score would be one that requires only variables that can be documented simply from routine laboratory tests without the need for sophisticated tests.Methods:Data from the estimation group (1351 patients) and the validation group (2208 patients) were retrospectively analysed. Liver fibrosis-negative control and liver cirrhosis were compared with HCC. Area under ROC curve (AUC) were used to develop HCC-α-fetoprotein-routine test (HCC-ART).Results:Hepatocellular carcinoma-AFP-routine test showed diagnostic accuracy for liver cirrhosis vs HCC with ROC curves of 0.99%, sensitivity of 97%, and specificity of 96% in the estimation, and 0.95%, 90%, and 83%, respectively, in the validation. Sensitivity (97%) and specificity (100%) were obtained to discriminate HCC from liver fibrosis. Area under curve for AFP at 400 U l−1 was 0.70, sensitivity was 41%, and specificity was 99% in the estimation, and 0.77%, 54%, and 99%, respectively, in the validation. The AUC for HCC-ART in HCC with single tumour, absent vascular invasion, size <2 cm and CLIP score (0–1) were 0.95, 0.93, 0.86, 0.87, respectively, compared with 0.72, 0.71, 0.71, 0.50, respectively, for AFP.Conclusion:Hepatocellular carcinoma-AFP-routine test could increase the accuracy of HCC screening and surveillances and could be used worldwide without extra efforts.

Serum peptide pattern that differentially diagnoses hepatitis B virus‐related hepatocellular carcinoma from liver cirrhosis

“…However, there is no significant difference ( P = 0.0561) on AUCs between the two algorithms by using StAR . The AUC of AFP is 0.751, which is similar to the report by Attallah . Obviously, the AUC of AFP is less than those of MLP or MLP + AFP ( P < 0.05).…”

GPC-HCC model: a combination of glybican-3 with other routine parameters improves the diagnostic efficacy in hepatocellular carcinoma

“…Also, the sensitivity and specificity of our model are higher than that of other HCC markers like for AFP, they were 61 and 71 %; for DCP, 39 and 90 %; for AFP-L3, 37 and 92 %; for dickkopf-1 (DKK1), 69.1 and 90.6; and for osteopontin (OPN), 74 and 66 %, respectively. Also, our outcomes are superior to that of AFP and AFP-L3 combination, 77 % sensitivity; AFP and DCP combination, 59 % sensitivity; and AFP, DKK1 and OPN combination, 88.76 % [6,[33][34][35][36]. Moreover, the GPC-HCC model has higher sensitivity than do other GPC3 and AFP combinations.…”

“…During liver impairment, decreased serum albumin is important and is already used to assess liver carcinogenesis. In chronic liver diseases, circulating albumin level is usually normal until cirrhosis and primary liver cancer development [3,6,21].…”

“…The sensitivity of US, CT, and MRI were 84, 79, and 77 %, respectively. The combination of these modulates the sensitivity to 90 %, in US and MRI; to 82 %, in US and CT; and 88 % in US and MRI [6]. Also, the sensitivity and specificity of our model are higher than that of other HCC markers like for AFP, they were 61 and 71 %; for DCP, 39 and 90 %; for AFP-L3, 37 and 92 %; for dickkopf-1 (DKK1), 69.1 and 90.6; and for osteopontin (OPN), 74 and 66 %, respectively.…”

“…Other biomarkers, like des-γ-carboxy pro-thrombin (DCP) and the Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), were proposed as complements for AFP, but their sensitivity were better than that of AFP only in large tumors [5]. Moreover, imaging technique results are strongly influenced by the skill of the examiner, the methods used, and the quality of the imaging apparatus [6]. Thus, future effective diagnostic HCC biomarker identification is crucial.…”