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Diagnostic value of 5 serum biomarkers for hepatocellular carcinoma with different epidemiological backgrounds:A large-scale,retrospective study

查看全文 作　　者：Dongming [1]Liu;Yi [2]Luo;Lu [1]Chen;Liwei [2]Chen;Duo [3]Zuo;Yueguo [3]Li;Xiaofang [4]Zhang;Jing [5]Wu;Qing [2]Xi;Guangtao [2]Li;Lisha [6]Qi;Xiaofen [7]Yue;Xiehua [8]Zhang;Zhuoyu [9]Sun;Ning [10]Zhang;Tianqiang [1]Song;Wei [1]Lu;Hua [2]Guo 高影响力作者 机构地区：[1]Department of Hepatobiliary,Liver Cancer Research Center for Prevention and Therapy,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Key Laboratory of Cancer Prevention and Therapy,Tianjin,Tianjin’s Clinical Research Center for Cancer,Tianjin 300060,China;[2]Department of Tumor Cell Biology,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Key Laboratory of Cancer Prevention and Therapy,Tianjin,Tianjin’s Clinical Research Center for Cancer,Tianjin 300060,China;[3]Clinical Laboratory,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Key Laboratory of Cancer Prevention and Therapy,Tianjin,Tianjin’s Clinical Research Center for Cancer,Tianjin 300060,China;[4]Medical Laboratory,Tianjin Medical University General Hospital,Tianjin 300052,China;[5]Clinical Laboratory,Tianjin Third Central Hospital,Tianjin 300170,China;[6]Department of Pathology,Tianjin Medical University Cancer Institute and Hospital,National Clinical Research Center for Cancer,Key Laboratory of Cancer Prevention and Therapy,Tianjin,Tianjin’s Clinical Research Center for Cancer,Tianjin 300060,China;[7]Department of Tianjin Research Institute of Liver Diseases,Tianjin Second People’s Hospital,Tianjin 300192,China;[8]Department of Infectious Diseases,The First Affiliated Hospital of Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014010,China;[9]Department of Epidemiology and Biostatistics,School of Public Health,Tianjin Medical University,Tianjin 300070,China;[10]The Center for Translational Cancer Research,Peking University First Hospital,Beijing 100034,China高影响力机构 出　　处：《Cancer Biology & Medicine》索引2021年第18卷第1期,共15页高影响力期刊 基　　金：supported by the National Natural Science Foundation of China(Grant Nos.81972656 and 31671421);the Key Project of Tianjin Natural Science Foundation(Grant No.18JCZDJC35200);the State Key Project on Infectious Diseases of China(Grant No.2018ZX10723204);the National 135 Major Project of China(2018ZX10302205)。 摘　　要：Objective:Hepatocellular carcinoma(HCC)is a lethal global disease that requires an accurate diagnosis.We assessed the potential of 5 serum biomarkers(AFP,AFU,GGT-II,GPC3,and HGF)in the diagnosis of HCC.Methods:In this retrospective study,we measured the serum levels of each biomarker using ELISAs in 921 participants,including 298 patients with HCC,154 patients with chronic hepatitis(CH),122 patients with liver cirrhosis(LC),and 347 healthy controls from 3 hospitals.Patients negative for hepatitis B surface antigen and hepatitis C antibody(called'NBNC-HCC')and patients positive for the above indices(called'HBV-HCC and HCV-HCC')were enrolled.The selected diagnostic model was constructed using a training cohort(n=468),and a validation cohort(n=453)was used to validate our results.Receiver operating characteristic analysis was used to evaluate the diagnostic accuracy.Results:Theα-L-fucosidase(AFU)/α-fetoprotein(AFP)combination was best able to distinguish NBNC-HCC[area under the curve:0.986(95%confidence interval:0.958–0.997),sensitivity:92.6%,specificity:98.9%]from healthy controls in the test cohort.For screening populations at risk of developing HCC(CH and LC),the AFP/AFU combination improved the diagnostic specificity for early-stage HCC[area under the curve:0.776(0.712–0.831),sensitivity:52.5%,specificity:91.6%in the test group].In all-stage HBV-HCC and HCV-HCC,AFU was also the best candidate biomarker combined with AFP[area under the curve:0.835(0.784–0.877),sensitivity 69.1%,specificity:87.4%in the test group].All results were verified in the validation group.Conclusions:The AFP/AFU combination could be used to identify NBNC-HCC from healthy controls and hepatitis-related HCC from at-risk patients. 关 键 词：Hepatocellular carcinoma SERUM BIOMARKER AFP AFU
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