Liver Cancer
Copyright ©The Author(s) 2005. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 21, 2005; 11(39): 6115-6119
Published online Oct 21, 2005. doi: 10.3748/wjg.v11.i39.6115
Usefulness of serum des-γ-carboxy prothrombin in detection of hepatocellular carcinoma
Chaur-Shine Wang, Chih-Lin Lin, Hsi-Chang Lee, Kuan-Yang Chen, Ming-Feng Chiang, Hung-Sheng Chen, Tsung-Jung Lin, Li-Ying Liao
Chaur-Shine Wang, Chih-Lin Lin, Hsi-Chang Lee, Kuan-Yang Chen, Ming-Feng Chiang, Hung-Sheng Chen, Tsung-Jung Lin, Li-Ying Liao, Department of Gastroenterology, Ren-Ai Branch, Taipei City Hospital, Taipei, Taiwan, China
Author contributions: All authors contributed equally to the work.
Supported by the Taipei Institute of Pathology, Taipei, Taiwan and Eisai Co., Tokyo, Japan
Correspondence to: Dr. Chaur-Shine Wang, Department of Gastroenterology, Ren-Ai Branch, Taipei City Hospital, No. 10, Sec. 4, Ren-ai Road, Da-an District Taipei City 106, Taiwan, China. lcl@tpech.gov.tw
Telephone: +886-2-27093600-1157 Fax: +886-2-27047859
Received: January 24, 2005
Revised: April 6, 2005
Accepted: April 9, 2005
Published online: October 21, 2005
Abstract

AIM: To evaluate whether DCP is better than AFP for differentiating HCC from nonmalignant liver disease and further evaluate the usefulness of DCP in early diagnosis of small HCC.

METHODS: Serum DCP and AFP levels were determined in 127 patients. Among these patients, 32 were with non-cirrhotic chronic hepatitis, 34 were with compensated cirrhosis, and 61 were with HCC. The cut-off value for the DCP and AFP were set as 40 mAU/mL and 20 ng/mL, respectively. To compare the diagnostic value of DCP and AFP in distinguishing HCC from nonmalignant chronic liver disease, receiver operating characteristic (ROC) curves were constructed for each assay.

RESULTS: The accuracy, sensitivity, and specificity of DCP were higher than AFP in detecting HCC (81.9%, 77%, and 86.4% vs 68.5%, 59%, and 77.3%, respectively). The area under the ROC (AUROC) curves revealed that DCP had a better accuracy than AFP in diagnosis of HCC (0.85 [95%CI, 0.78-0.91] vs 0.73 [95%CI, 0.65-0.81], P = 0.013). In 39 patients with solitary HCC, the positive rates of DCP were 100% in patients with tumor size larger than 3 cm, 66.7% in patients with tumor size 2-3 cm and 50% in patients with tumor size less than 2 cm. The positive rates of AFP in patients with tumor size larger than 3 cm, 2-3 cm and less than 2 cm were 55.6%, 50%, and 33.3%, respectively. The median level of DCP in HCC patients with tumor size larger than 3 cm was significantly higher than those with tumor size 2-3 cm and those with the size of less than 2 cm.

CONCLUSION: Our study indicates that DCP has a better diagnostic value than AFP in differentiating HCC from nonmalignant chronic liver disease. DCP has not only a stronger correlation with HCC than AFP in tumor size but also more effectiveness than AFP in detecting small size of HCC.

Keywords: Des-γ-carboxy prothrombin; α-Fetoprotein; Hepatocellular carcinoma