Evaluation of serum AFP and DCP levels in the diagnosis of early-stage HBV-related HCC under different backgrounds

J Int Med Res. 2020 Oct;48(10):300060520969087. doi: 10.1177/0300060520969087.

Abstract

Objective: This study compared the diagnostic performance of alpha-fetoprotein (AFP) and des-gamma-carboxyprothrombin (DCP) in early-stage hepatitis B virus-related hepatocellular carcinoma (HBV-HCC) under different backgrounds.

Methods: Patients were enrolled and divided in four groups: chronic HBV infection (CHB), liver cirrhosis (LC), early-stage CHB-HCC, and early-stage LC-HCC. Serum AFP and DCP levels were measured. Receiver-operating characteristic (ROC) curve and area under the curve (AUC) analyses were applied to compare the diagnostic performance of DCP and AFP for HCC.

Results: In total, 200 patients were enrolled, including 48, 64, 33, and 55 patients with CHB, LC, CHB-HCC, and LC-HCC, respectively. ROC curve analysis revealed that the AUCs of AFP, DCP, and their combination in differentiating early-stage LC-HCC from LC were 0.776, 0.758, and 0.786, respectively. The values of these markers in discriminating early-stage CHB-HCC from CHB were 0.828, 0.731, and 0.862, respectively.

Conclusions: DCP was inferior to AFP in differentiating early-stage CHB-HCC from CHB. However, AFP and DCP displayed similar performance in distinguishing early-stage LC-HCC and LC.

Keywords: Des-gamma-carboxyprothrombin; alpha-fetoprotein; chronic hepatitis B; diagnostic performance; hepatitis B virus; hepatocellular carcinoma; liver cirrhosis.

MeSH terms

  • Biomarkers / blood
  • Biomarkers, Tumor
  • Carcinoma, Hepatocellular* / diagnosis
  • Carcinoma, Hepatocellular* / virology
  • Hepatitis B / diagnosis*
  • Hepatitis B virus
  • Humans
  • Liver Neoplasms* / virology
  • Protein Precursors / blood
  • Prothrombin
  • ROC Curve
  • alpha-Fetoproteins / analysis

Substances

  • Biomarkers
  • Biomarkers, Tumor
  • Protein Precursors
  • alpha-Fetoproteins
  • acarboxyprothrombin
  • Prothrombin