Brief Article
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World J Gastroenterol. May 28, 2013; 19(20): 3143-3149
Published online May 28, 2013. doi: 10.3748/wjg.v19.i20.3143
Value of circulating cell-free DNA in diagnosis of hepatocelluar carcinoma
Ken Chen, Hong Zhang, Li-Na Zhang, Shao-Qing Ju, Jing Qi, Dong-Feng Huang, Feng Li, Qun Wei, Jing Zhang
Ken Chen, Hong Zhang, Li-Na Zhang, Dong-Feng Huang, Feng Li, Qun Wei, Jing Zhang, Department of Gastroenterology, Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu Province, China
Shao-Qing Ju, Jing Qi, Center of Laboratory Medicine, Affiliated Hospital of Nantong University, Nantong 226000, Jiangsu Province, China
Author contributions: Chen K and Zhang H contributed equally to this work; Chen K and Zhang H designed the research; Chen K, Zhang H, Zhang LN, Ju SQ and Qi J performed the research; Ju SQ provided new reagents; Huang DF, Li F and Wei Q analyzed the data; Chen K, Zhang H and Zhang J wrote the manuscript.
Correspondence to: Hong Zhang, MD, Department of Gastroenterology, Affiliated Hospital of Nantong University, 20 Xisi Street, Nantong 226000, Jiangsu Province, China. zhangh111@sina.com
Telephone: +86-513-85052461 Fax: +86-513-85052588
Received: December 12, 2012
Revised: April 8, 2013
Accepted: April 18, 2013
Published online: May 28, 2013
Abstract

AIM: To investigate the value of combined detection of circulating cell-free DNA (cfDNA), α-fetal protein (AFP) and α L-fucosidase (AFU) for diagnosis of hepatocellular carcinoma (HCC).

METHODS: Serum samples from 39 HCC patients and 45 normal controls were collected. Branched DNA (bDNA) was used to detect the level of cfDNA, and a receiver operating characteristic curve was employed to evaluate the diagnostic sensitivity, specificity, accuracy, positive predictive value, negative predictive value, positive likelihood ratio, negative likelihood ratio and Youden index, and to assess the diagnostic efficiency and their correlations with the clinicopathological features. AFP and AFU were detected by chemiluminescence and colorimetry, respectively. The significance of combined detection of the three biomarkers was discussed.

RESULTS: cfDNA level was increased in 22 of the 39 HCC samples and in 2 of the 45 normal controls. cfDNA level in HCC samples was significantly higher than that in normal controls (P < 0.05). There were significant differences in sex and extra- and intrahepatic metastasis (P < 0.05). There was no significant correlation between cfDNA, AFP and AFU in the detection of HCC. The sensitivity of combined detection of cfDNA with one marker (AFP or AFU) and cfDNA with two markers (AFP and AFU) was 71.8%, 87.2% and 89.7% vs 56.4%, 53.8% and 66.7% for cfDNA, AFP and AFU used alone, respectively, the difference being statistically significant (P < 0.05).

CONCLUSION: Quantitative analysis of cfDNA is sensitive and feasible, and the combined detection of cfDNA with AFP or AFU or both could improve the diagnostic sensitivity for HCC.

Keywords: Alu, Branched DNA, Circulating cell free DNA, Diagnosis, Hepatocellular carcinoma

Core tip: Various techniques are available to quantify serum circulating free cell DNA (cfDNA), some of these techniques require abstraction and purification as there is only a very small amount of cfDNA in the serum. This study investigates the value of combined detection of cfDNA, α-fetal protein (AFP) and α L-fucosidase (AFU) for diagnosis of hepatocellular carcinoma. Quantitative analysis of cfDNA is sensitive and feasible, and the combined detection of cfDNA with AFP or AFU or both could improve the diagnostic sensitivity for hepatocellular carcinoma.