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      • Record: found
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      A meta-analysis and of clinical values of 11 blood biomarkers, such as AFP, DCP, and GP73 for diagnosis of hepatocellular carcinoma

      systematic-review
      Author(s): a , b , c , c , c
      Publication date (Electronic, pub):
      Publication date (Electronic, collection):
      Journal: Annals of Medicine
      Publisher: Taylor & Francis
      Keywords: Biomarkers, HCC, the diagnostic value, meta-analysis

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          Abstract

          Background

          Hepatocellular carcinoma lacks ideal diagnostic biomarkers. There is a lack of scientific evaluation of relevant promising biomarkers as well. Therefore this study reanalyzes the related studies of 11 blood biomarkers of HCC, and compares the diagnostic value of these biomarkers for HCC systematically.

          Methods

          The relevant literatures on the diagnostic value in HCC of 11 blood indexes in recent 5 years were searched in PubMed, Embase, and Cochrane libraries. Data were extracted and analyzed.

          Results

          Finally, 83 literature studies were brought into meta-analysis. The pooled sensitivity and specificity of AFP were 0.61 and 0.87, respectively. The AUC of AFP were 0.78. The AUC and sum of sensitivity and specificity of the combination of AFP and other biomarkers were all significantly higher than that of AFP, including AFP + AFP-L3 + DCP, AFP + DCP, AFP/DCP, AFP + GPC3. Among other biomarkers, the AUC and sum of sensitivity and specificity of biomarkers including DCP, GPC3, GP73, Hsp90alpha, midkine, and OPN were significantly higher than that of AFP. In this study, GP73 had the highest sum of sensitivity and specificity (1.78) and AUC (0.95).

          Conclusions

          The pooled sensitivity and specificity of AFP were 0.61 and 0.87, respectively. The AUC of AFP were 0.78. The combination of AFP and other biomarkers improved the diagnostic efficiency. The diagnostic value of biomarkers including DCP, GPC3, GP73, Hsp90alpha, midkine, and OPN was higher than that of AFP. GP73 had the best diagnostic value for HCC with the highest sum of sensitivity and specificity (1.78) and AUC (0.95).

          KEY MESSAGES

          • The pooled sensitivity and specificity of AFP were 0.61 and 0.87, respectively. The AUC of AFP were 0.78. The combination of AFP and other biomarkers improved the diagnostic efficiency of HCC.

          • The diagnostic value of biomarkers including DCP, GPC3, GP73, Hsp90alpha, midkine, and OPN was higher than that of AFP.

          • GP73 had the best diagnostic value for HCC.

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          Most cited references98

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          Longitudinal Assessment of Three Serum Biomarkers to Detect Very Early Stage Hepatocellular Carcinoma

          Jonggi Choi, Gi-Ae Kim, Seungbong Han … (2018)
          We aimed to determine the surveillance performance of alpha-fetoprotein (AFP), lectin-reactive AFP (AFP-L3), des-gamma-carboxy prothrombin (DCP), and their combinations for the early detection of hepatocellular carcinoma (HCC) by using prospectively collected longitudinal samples in patients at risk. Among 689 patients with cirrhosis and/or chronic hepatitis B who participated in four prospective studies, 42 HCC cases were diagnosed, selected, and matched with 168 controls for age, sex, etiology, cirrhosis, and duration of follow-up in a 1:4 ratio. Levels of AFP, AFP-L3, and DCP at the time of HCC diagnosis, month -6, and month -12 were compared between cases and controls. Of 42 HCC cases, 39 (93%) had cirrhosis, 36 (85.7%) had normal alanine aminotransferase levels, and 31 (73.8%) had very early-stage HCC (single <2 cm). AFP and AFP-L3 began to increase from 6 months before diagnosis of HCC in cases (P < 0.05), while they remained unchanged in controls. At HCC diagnosis, the area under the receiver operator characteristic curves (AUROCs) for AFP, AFP-L3, and DCP were 0.77, 0.73, and 0.71, respectively. Combining AFP and AFP-L3 showed a higher AUROC (0.83), while adding DCP did not further improve the AUROC (0.86). With the optimal cutoff values (AFP, 5 ng/mL; AFP-L3, 4%), the sensitivity and specificity of AFP and AFP-L3 combination were 79% and 87%, respectively. The sensitivity of ultrasonography was 48.6%, which was increased to 88.6% and 94.3% by adding AFP and AFP + AFP-L3, respectively. Conclusion: Among three biomarkers, AFP showed the best performance in discriminating HCC cases from controls; the AFP and AFP-L3 combination, adopting cutoff values (5 ng/mL and 4%, respectively), significantly improved the sensitivity for detecting HCC at a very early stage.
          Article 0 comments Cited 85 times – based on 0 reviews     Review now
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            Usefulness of AFP, AFP-L3, and PIVKA-II, and their combinations in diagnosing hepatocellular carcinoma

            Sang Joon Park, Jae Young Jang, Soung Jeong … (2017)
            Supplemental Digital Content is available in the text
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              New Blood Biomarkers for the Diagnosis of AFP-Negative Hepatocellular Carcinoma

              Ting Wang, Kun-He Zhang (2020)
              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.
              Article 0 comments Cited 69 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Ann Med
                Journal ID (iso-abbrev): Ann Med
                Title: Annals of Medicine
                Publisher: Taylor & Francis
                ISSN (Print): 0785-3890
                ISSN (Electronic): 1365-2060
                Publication date (Electronic, pub): 8 December 2022
                Publication date (Electronic, collection): 2023
                Publication date PMC-release: 8 December 2022
                Volume: 55
                Issue: 1
                Pages: 42-61
                Affiliations
                [a ]Changchun University of Traditional Chinese Medicine , Changchun, Jilin, China
                [b ]Department of Hepatology, The Affiliated Hospital of Changchun University of Traditional Chinese Medicine , Changchun, Jilin, China
                [c ]Department of Cardiology, The Affiliated Hospital of Changchun University of Traditional Chinese Medicine , Changchun, Jilin, China
                Author notes
                [*]

                These authors contributed equally to this work.

                CONTACT Li-hong Jiang ccucm_jlh@ 123456outlook.com Department of Cardiology, The Affiliated Hospital of Changchun University of Traditional Chinese Medicine , 1478 Gongnong Rd, Changchun, Jilin, 130000, China
                Author information
                https://orcid.org/0000-0002-1194-2218
                https://orcid.org/0000-0003-2052-8892
                https://orcid.org/0000-0003-4706-715X
                https://orcid.org/0000-0002-4375-940X
                https://orcid.org/0000-0003-0679-8394
                Article
                Publisher ID: 2153163
                DOI: 10.1080/07853890.2022.2153163
                PMC ID: 9744221
                PubMed ID: 36476015
                SO-VID: 5db6fbf4-55b2-456e-87be-846fc1929d99
                Copyright © © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.
                License:

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                Page count
                Figures: 10, Tables: 4, Pages: 20, Words: 9743
                Categories
                Subject: Systematic Review
                Subject: Gastroenterology & Hepatology

                ScienceOpen disciplines: Medicine
                Keywords: biomarkers,hcc,the diagnostic value,meta-analysis
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: biomarkers, hcc, the diagnostic value, meta-analysis

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