Present and future possibilities for early diagnosis of hepatocellular carcinoma

Table 1 HCC risk development factors (%)[4]

	Europe	North America	Asia & Africa	Japan
HCV	60-70	50-60	20	70
HBV	10-15	20	70	10-20
ALC	20	20	10	10
Other	10	10	0	0

HCC: Hepatocellular carcinoma; HCV: Hepatitis C virus; HBV: Hepatitis B virus; ALC: Alcohol abuse.

Table 2 HCC specific risk groups (AASLD Practice Guideline 2005)[7]

Hepatitis B carriers	Non-hepatitis B carriers
Cirrhotic patients (incidence of HCC: 3%-5%/year)	Hepatitis C (incidence of HCC: 2%-8%/year)
Non-cirrhotic patients with high HBV DNA and hepatitis activity	Alcoholic cirrhosis
Positive family history of HCC	Genetic hemochromatosis
Asian males > 40 years (incidence of HCC: 0.4%-0.6%/year)	Primary biliary cirrhosis and autoimmune hepatitis
Asian females > 50 years (incidence of HCC: 0.2%/year)	α1-antitrypsin deficiency
Africans > 20 years (incidence of HCC: > 0.2%/year)	Non-alcoholic steatohepatitis

Table 3 Diagnostic values of AFP as HCC biomarker[20,21]

Cut-off value (μg/L)	Sensitivity (%)	Specificity (%)	Ref.
20	55-60	88-90	[21,22]
50	47.0	96.0	[22]
100	31.2	98.8	[21]
200	22.4	99.4	[21]
400	17.1	99.4	[21]

AFP: α-fetoprotein.

Table 4 Diagnostic values of HCC serum markers[34-36]

Type of test	Sensitivity (%)	Specificity (%)
AFP-L3	61.60[34]	92.00[35]
DCP	72.70[34]	90.00[35]
AFP	67.70[34]	71.00[35]
AFP-L3+DCP	84.80[34]	97.80[37]
AFP-L3+AFP	73.70[34]	86.60[35,36]
DCP+AFP	84.80[34]	90.20[35]
AFP-L3+DCP+AFP	85.90[34]	59.00[35]

DCP: Des-γ-carboxyprothrombin.