Risk factors for hepatocellular carcinoma may impair the performance of biomarkers: A comparison of AFP, DCP, and AFP-L3

Michael L. Volk, Jose C. Hernandez, Grace L. Su, Anna S. Lok, Jorge A. Marrero

Research output: Contribution to journalArticlepeer-review

103 Scopus citations

Abstract

Current surveillance strategies for hepatocellular carcinoma (HCC) are applied uniformly in patients with cirrhosis, regardless of their cancer risk. The aim of this study was to compare the performance characteristics of the biomarkers alpha-fetoprotein (AFP), des-gamma carboxyprothrombin (DCP), and lectin-bound AFP (AFP-L3) in the diagnosis of HCC, and to determine the effect of risk factors for HCC on test performance. Eighty-four patients with HCC and 169 patients with cirrhosis were enrolled and their serum analyzed for total AFP, AFP-L3 and DCP. Receiver-operating characteristic (ROC) curves were constructed to determine the performance characteristics. DCP was significantly better than total AFP or AFP-L3 in differentiating HCC from cirrhosis, with a sensitivity of 86% and specificity of 93%. When subjects were divided into two groups by their risk for HCC, all 3 markers had a lower sensitivity and area under the ROC curve in the high-risk group compared to the low-risk group. In conclusion, DCP has the best performance characteristics of all 3 serum markers for the diagnosis of HCC. Serum biomarkers may be less sensitive and specific in the highest risk patients.

Original languageEnglish (US)
Pages (from-to)79-87
Number of pages9
JournalCancer Biomarkers
Volume3
Issue number2
DOIs
StatePublished - 2007

Keywords

  • Alpha-fetoprotein
  • Biomarkers
  • Des-gamma-carboxyprothrombin
  • Hepatocellular carcinoma
  • Lectin-bound AFP
  • Risk factors

ASJC Scopus subject areas

  • Oncology
  • Genetics
  • Cancer Research

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