Simple and robust diagnosis of early, small and AFP-negative primary hepatic carcinomas: an integrative approach of serum fluorescence and conventional blood tests

Wang, Ting; Zhang, Kun‐He; Hu, Piao-Ping; Huang, Zeng-Yong; Zhang, Pan; Wan, Qin-Si; Huang, Deqiang; Lv, Nonghua

doi:10.18632/oncotarget.11771

Cited by 8 publications

(14 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In addition, the expression levels of cfDNA were not associated with patient age, gender, TNM stage, or AFP levels or protein induced by vitamin K absence (PIVKA-II) ( 38 ), and serum cfDNA levels could be directly, simply, and accurately detected by a real-time PCR system, which enhances their clinical application for the diagnosis of ANHC. We found that cfDNA-related fluorescence intensity and serum autofluorescence intensity were of value for the diagnosis of early, small, AFP-negative, and all primary hepatic carcinomas from liver cirrhosis (LC), chronic hepatitis, and normal control, with an AUROC value of 0.777–0.963 in the training set and 0.764–0.972 in the validation set, of which the two fluorescence intensity indicators had an AUROC of 0.836, a sensitivity of 73.6%, a specificity of 79.7%, and an accuracy of 78.6% for differentiating ANHC from non-HCC ( 39 , 40 ), and their diagnostic value could be improved by combination with AFP, hepatic function tests, and/or blood cell analyses.…”

Section: Blood Biomarkers For Anhc Diagnosismentioning

confidence: 99%

New Blood Biomarkers for the Diagnosis of AFP-Negative Hepatocellular Carcinoma

2020

Self Cite

View full text Add to dashboard Cite

An early diagnosis of hepatocellular carcinoma (HCC) followed by effective treatment is currently critical for improving the prognosis and reducing the associated economic burden. Alpha-fetoprotein (AFP) is the most widely used biomarker for HCC diagnosis. Based on elevated serum AFP levels as well as typical imaging features, AFP-positive HCC (APHC) can be easily diagnosed, but AFP-negative HCC (ANHC) is not easily detected due to lack of ideal biomarkers and thus mainly reliance on imaging. Imaging for the diagnosis of ANHC is probably insufficient in sensitivity and/or specificity because most ANHC tumors are small and early-stage HCC, and it is involved in sophisticated techniques and high costs. Moreover, ANHC accounts for nearly half of HCC and exhibits a better prognosis compared with APHC. Therefore, the diagnosis of ANHC in clinical practice has been a critical issue for the early treatment and prognosis improvement of HCC. In recent years, tremendous efforts have been made to discover new biomarkers complementary to AFP for HCC diagnosis. In this review, we systematically review and discuss the recent advances of blood biomarkers for HCC diagnosis, including DNA biomarkers, RNA biomarkers, protein biomarkers, and conventional laboratory metrics, focusing on their diagnostic evaluation alone and in combination, in particular on their diagnostic performance for ANHC.

show abstract

Section: Blood Biomarkers For Anhc Diagnosismentioning

confidence: 99%

New Blood Biomarkers for the Diagnosis of AFP-Negative Hepatocellular Carcinoma

2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…Adrian et al [46] reported that the baseline AFP concentration was ≥ 20 ng/mL in 191 of 1145 patients (16.6%) with advanced chronic hepatitis C without HCC; simultaneously, the mean AFP values were also significantly higher in cirrhosis than in bridging fibrosis (22.5 vs. 11.4 ng/mL). Moreover, due to nearly 40% of patients with PHC are of AFP-negative (< 20 ng/mL), [47] the overall performance of AFP is easily disturbed and may be far from satisfactory as a metastatic marker.…”

Section: Discussionmentioning

confidence: 99%

Pretreatment risk management of a novel nomogram model for prediction of thoracoabdominal extrahepatic metastasis in primary hepatic carcinoma

Hu¹,

Wang²,

Zhang³

et al. 2019

J Transl Med

Self Cite

View full text Add to dashboard Cite

Background Extrahepatic metastasis is the independent risk factor of poor survival of primary hepatic carcinoma (PHC), and most occurs in the chest and abdomen. Currently, there is still no available method to predict thoracoabdominal extrahepatic metastasis in PHC. In this study, a novel nomogram model was developed and validated for prediction of thoracoabdominal extrahepatic metastasis in PHC, thereby conducted individualized risk management for pretreatment different risk population. Methods The nomogram model was developed in a primary study that consisted of 330 consecutive pretreatment patients with PHC. Large-scale datasets were extracted from clinical practice. The nomogram was based on the predictors optimized by data dimension reduction through Lasso regression. The prediction performance was measured by the area under the receiver operating characteristic (AUROC), and calibrated to decrease the overfit bias. Individualized risk management was conducted by weighing the net benefit of different risk population via decision curve analysis. The prediction performance was internally and independently validated, respectively. An independent-validation study using a separate set of 107 consecutive patients. Results Four predictors from 55 high-dimensional clinical datasets, including size, portal vein tumor thrombus, infection, and carbohydrate antigen 125, were incorporated to develop a nomogram model. The nomogram demonstrated valuable prediction performance with AUROC of 0.830 (0.803 in internal-validation, and 0.773 in independent-validation, respectively), and fine calibration. Individual risk probability was visually scored. Weighing the net benefit, threshold probability was classified for three-independent risk population, which was < 19.9%, 19.9–71.8% and > 71.8%, respectively. According to this classification, pretreatment risk management was based on a treatment-flowchart for individualized clinical decision-making. Conclusions The proposed nomogram is a useful tool for pretreatment risk management of thoracoabdominal extrahepatic metastasis in PHC for the first time, and may handily facilitate timely individualized clinical decision-making for different risk population. Electronic supplementary material The online version of this article (10.1186/s12967-019-1861-z) contains supplementary material, which is available to authorized users.

show abstract

“…The system was superior to the combinations of the three markers alone. We previously combined conventional blood tests with serum fluorescence by logistic models and achieved excellent diagnostic performances for early, small and AFP-negative PHC [ 14 ]. In the present study, the diagnostic model FPHA-M established with indicators of serum fluorescence intensity, AFP, hepatic function tests and age exhibited the best performance for differentiating HCC from BLD among all models of combinations of different indicators.…”

Section: Discussionmentioning

confidence: 99%

“…The autofluorescence intensity and cfDNA-related fluorescence intensity of serum specimens were measured by the method that we previously established [ 14 ] and simplified in this study (Figure 3 ), which was performed in a real-time PCR system at the excitation and emission wavelengths of 490 nm and 525 nm, respectively. Six fluorescence indicators were obtained after measurement, including 2 original serum autofluorescence indicators (FST8 and FST37), 2 original cfDNA-related fluorescence indicators (FST8E and FST37E) and 2 derived cfDNA-related fluorescence indicators (FERST8 and FERST37).…”

Section: Methodsmentioning

confidence: 99%

“…The AUROCs of cfDNA alone and combined with AFP for diagnosing HCC were 0.87 and 0.96, respectively [ 13 ]. Previously, we developed a simple and robust approach for noninvasively diagnosing primary hepatic carcinomas (PHC) using a combination of serum autofluorescence and cfDNA-related fluorescence sequentially detected with AUROCs of 0.773 and 0.799 for distinguishing PHC from LC and CH, respectively, and these diagnostic values are improved by combining the two types of serum fluorescence with AFP, hepatic function tests and blood cell analyses with AUROCs of 0.916 and 0.945 [ 14 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Combination of dual serum fluorescence, AFP and hepatic function tests is valuable to identify HCC in AFP-elevated liver diseases

Wang

Zhang

et al. 2017

Oncotarget

Self Cite

View full text Add to dashboard Cite

Serum alpha-fetoprotein (AFP) levels elevated in benign liver diseases (BLD) represent a challenge in hepatocellular carcinoma (HCC) diagnosis. The present study aimed to develop a simple method to identify HCC in AFP-elevated liver diseases based on combining serum fluorescence and general clinical data. Serum specimens and clinical data were collected from 201 HCC and 117 BLD (41 liver cirrhosis, 76 chronic hepatitis) patients with abnormal serum AFP levels. Dual serum fluorescence (autofluorescence and cell-free DNA-related fluorescence) intensities were sequentially measured and expressed as 6 fluorescence indicators. The diagnostic value of these fluorescence and clinical data were evaluated alone and in combination by the area under receiver operating characteristic curve (AUROC). All fluorescence indicators significantly differed between HCC and BLD and some of them were more valuable for diagnosing HCC than AFP (AUROC 0.782–0.801 vs. 0.752). The diagnostic model established with fluorescence indicators, AFP, hepatic function tests and age showed that AUROC, sensitivity, specificity and accuracy were 0.958 (95% CI 0.936–0.979), 92.0%, 88.9% and 92.3%, respectively, and positive rates in AFP-negative, early and small HCCs were 73.8%, 81.6% and 74.3%, respectively. In conclusion, the combination of dual serum fluorescence, AFP, hepatic function tests and age is simple and valuable for identifying HCC in serum AFP-elevated liver diseases.

show abstract

Simple and robust diagnosis of early, small and AFP-negative primary hepatic carcinomas: an integrative approach of serum fluorescence and conventional blood tests

Cited by 8 publications

References 29 publications

New Blood Biomarkers for the Diagnosis of AFP-Negative Hepatocellular Carcinoma

New Blood Biomarkers for the Diagnosis of AFP-Negative Hepatocellular Carcinoma

Pretreatment risk management of a novel nomogram model for prediction of thoracoabdominal extrahepatic metastasis in primary hepatic carcinoma

Combination of dual serum fluorescence, AFP and hepatic function tests is valuable to identify HCC in AFP-elevated liver diseases

Contact Info

Product

Resources

About