Serum Des-Gamma-Carboxy Prothrombin Levels Determined by A New Generation of Sensitive Immunoassays in Patients With Small-Sized Hepatocellular Carcinoma

Nomura, Fumio; Ishijima, Michikuni; Kuwa, Katsuhiko; Tanaka, Naomi; Nakai, Toshiaki; Ohnishi, Kunihiko

doi:10.1111/j.1572-0241.1999.00930.x

Cited by 106 publications

(55 citation statements)

References 18 publications

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“…Finally, 17 articles were included in our study (Fig. 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].…”

Section: Resultsmentioning

confidence: 99%

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%

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

et al. 2007

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“…The sensitivity of PIVKAII in the diagnosis of patients with HCC had been about 55% using a conventional kit (EI-test mono-P-II kit, Eisai Laboratory) before 1998. Several studies on the contrasting sensitivity kit and the conventional kit confirmed that the new kit is more sensitive than the conventional one in diagnosing HCC patients after 1998 (Mita et al, 1998;Nomura et al, 1999). The sensitivity is about 65% in patients diagnosed with HCC (Mita et al, 1998).…”

Section: Discussionmentioning

confidence: 96%

Diagnostic value of protein induced by vitamin K absence (PIVKAII) and hepatoma-specific band of serum gamma-glutamyl transferase (GGTII) as hepatocellular carcinoma markers complementary to α-fetoprotein

Zhang

et al. 2003

Br J Cancer

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Serum protein induced by vitamin K absence or antagonist II (PIVKAII), hepatoma-specific band of serum gamma-glutamyl transferase (GGTII), and a-fetoprotein (AFP) levels were determined in 120 patients with hepatocellular carcinoma (HCC) and 90 patients with cirrhosis. The mean serum concentration of PIVKAII in HCC patients was higher than that in cirrhotic patients. A total of 53.3% of patients (64 out of 120) with HCC had PIVKAII levels above 40 mAU ml À1 . However, only 13 patients with cirrhosis had higher PIVKA II levels. Of 32 small HCC patients, 13 (40.6%) had PIVKAII values above 40 mAU ml À1 . An increased concentration of AFP (i.e. 20 ng ml À1 ) was observed in 70 out of 120 (58.3%) patients with HCC and in 33 out of 90 (36.7%) patients with cirrhosis. Positive GGTII was found in 74.0% (89 out of 120) cases of HCC (sensitivity), in 16 of 90 cases of cirrhosis, and 14 of 32 (43.8%) small HCC patients had GGTII positive. No significant correlation was found between serum levels of AFP and PIVKAII. Combining the information from PIVKAII, AFP, and GGTII significantly increases the sensitivity over AFP alone. PIVKAII and GGTII are useful tumour markers complementary to AFP for diagnosis of HCC.

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“…Furthermore, the level of AFP is elevated in patients with both HCC and chronic liver disease; thus, there is wide overlapping between the two groups [144,145]. Most studies adopt a cutoff value of 20 ng/mL for AFP, with a sensitivity ranging from 49 to 71% and specificity from 49 to 86% in HCCs smaller than 5 cm [146][147][148][149][150][151][152][153][154]. Limitations in the sensitivity and specificity of AFP in surveillance of high-risk populations have led to the use of US as an additional method for the detection of HCC [142,[155][156][157].…”

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confidence: 99%

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

et al. 2010

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Introduction The Asian Pacific Association for the Study of the Liver (APASL) convened an international working party on the management of hepatocellular carcinoma (HCC) in December 2008 to develop consensus recommendations. Methods The working party consisted of expert hepatologist, hepatobiliary surgeon, radiologist, and oncologist from Asian-Pacific region, who were requested to make drafts prior to the consensus meeting held at Bali, Indonesia on 4 December 2008. The quality of existing evidence and strength of recommendations were ranked from 1 (highest) to 5 (lowest) and from A (strongest) to D (weakest), respectively, according to the Oxford system of evidence-based approach for developing the consensus statements. 123Hepatol Int (2010) 4: 439-474 DOI 10.1007/s12072-010-9165-7 Results Participants of the consensus meeting assessed the quality of cited studies and assigned grades to the recommendation statements. Finalized recommendations were presented at the fourth APASL single topic conference on viral-related HCC at Bali, Indonesia and approved by the participants of the conference.

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Serum Des-Gamma-Carboxy Prothrombin Levels Determined by A New Generation of Sensitive Immunoassays in Patients With Small-Sized Hepatocellular Carcinoma

Abstract: Compared with the conventional method, the sensitivity in detecting small-sized HCC was increased in the two new DCP immunoassays (ECLIA and IRMA). The overall performance as evaluated by an ROC analysis was significantly better in ECLIA than in IRMA.

Cited by 106 publications

References 18 publications

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

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

Diagnostic value of protein induced by vitamin K absence (PIVKAII) and hepatoma-specific band of serum gamma-glutamyl transferase (GGTII) as hepatocellular carcinoma markers complementary to α-fetoprotein

Asian Pacific Association for the Study of the Liver consensus recommendations on hepatocellular carcinoma

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