A Combination of α-Fetoprotein and Des-γ-Carboxy Prothrombin Is Superior in Detection of Hepatocellular Carcinoma

@article{Ertle2013ACO,
  title={A Combination of $\alpha$-Fetoprotein and Des-$\gamma$-Carboxy Prothrombin Is Superior in Detection of Hepatocellular Carcinoma},
  author={Judith Ertle and Dominik Heider and Marc Wichert and Benedikt Keller and Robert Kueper and Philip Hilgard and Guido Gerken and Joerg Friedrich Schlaak},
  journal={Digestion},
  year={2013},
  volume={87},
  pages={121 - 131}
}
Background and Aim: The incidence of hepatocellular carcinoma (HCC) is increasing in western countries. Despite its low sensitivity, the diagnosis of HCC still depends on detection of α-fetoprotein (AFP). Therefore, the aim of this study was to evaluate the combined analysis of AFP and des-γ-carboxy prothrombin (DCP) in a European cohort. Methods: We performed a single-center study (164 HCC/422 controls), in which the serum concentrations of AFP and DCP were determined. Results: AFP and DCP… 

Figures and Tables from this paper

Clinical Utility of Protein Induced by Vitamin K Absence-II in Patients with Hepatocellular Carcinoma

Assessment of clinical utility of Prothrombin induced by Vitamin K absence-II (PIVKAII) in addition to AFP in patients with HCC found values were significantly elevated with tumor size > 5 cm, tumor nodules > 3, and macrovascular invasion.

Alpha-fetoprotein and des-gamma-carboxy-prothrombin at twenty-four weeks after interferon-based therapy predict hepatocellular carcinoma development.

It is suggested that the elevation of AFP and DCP levels at 24 wk after the completion of IFN and ribavirin therapy were strongly associated with the incidence of HCC irrespective of virological response among Japanese LC-C patients.

Diagnostic values of alpha-fetoprotein, dickkopf-1, and osteopontin for hepatocellular carcinoma

The combined use of AFP, DKK1, and OPN as a biomarker panel could enhance the diagnostic ability for HCC.

Diagnostic accuracy of des‐gamma‐carboxy prothrombin for hepatocellular carcinoma in a French cohort using the Lumipulse® G600 analyzer

It is concluded that DCP outperformed AFP for the detection of HCC, in comparison with alpha‐fetoprotein in a French cohort using a new analyser.

The threshold of alpha-fetoprotein (AFP) for the diagnosis of hepatocellular carcinoma: A systematic review and meta-analysis

AFP levels in serum showed good accuracy in HCC diagnosis, and the threshold of AFP with 400 ng/mL was better than that of 200 ng/ mL in terms of sensitivity and specificity no matter AFP is used alone or combined with ultrasound.

The Combined Diagnostic Accuracy of Serum Alpha Fetoprotein and Des-Gamma Carboxyprothrombin in Hepatocellular Carcinoma among Chronic Liver Disease Patients in Ilorin

Combining these two tumour markers does not significantly improve the diagnostic accuracy of HCC and chronic HBV remains a strong aetiological agent of H CC in UITH, Ilorin.

Diagnostic Accuracy of PIVKA-II, Alpha-Fetoprotein and a Combination of both in Diagnosis of Hepatocellular Carcinoma in Patients Affected by Chronic HCV Infection.

PIVKA II, when combined with AFP, may be considered as a screening test for HCC due to its high negative predictive value.

A Systematic Review of Des-γ-Carboxy Prothrombin for the Diagnosis of Primary Hepatocellular Carcinoma

DCP has moderate diagnostic utility for PHC, although the above conclusion requires further support from additional high-quality studies.

Diagnostic value of prothrombin induced by the absence of vitamin K or antagonist-II (PIVKA-II) for early stage HBV related hepatocellular carcinoma

Serum PIVka-II level is a potential marker for early diagnosis of HCC and microvascular invasion and the use of PIVKA-II may improve assessment of tumor prognosis and guide development of therapeutic strategy.
...

References

SHOWING 1-10 OF 37 REFERENCES

Prognostic and diagnostic value of des-γ-carboxy prothrombin in liver cancer.

The data presented above demonstrate the importance of DCP in formulating a prognosis for patients with HCC, and the specificity of the DCP assay appears to be superior to that of AFP.

Alpha-fetoprotein, des-gamma carboxyprothrombin, and lectin-bound alpha-fetoprotein in early hepatocellular carcinoma.

AFP was more sensitive than DCP and AFP-L3% for the diagnosis of early and very early stage HCC at a new cutoff of 10.9 ng/mL.

Development of des-γ-carboxy prothrombin (DCP) measuring reagent using the LiBASys clinical analyzer

The LiBASys clinical analyzer made possible measurement of the complementary tumor markers, HCC, total AFP, AFP-L3 and DCP, which was significantly correlated with that measured with the ELISA method.

A study about mechanisms of des-gamma-carboxy prothrombin's production in hepatocellular carcinoma.

DCP detectable serum levels are the result not only of vitamin K deficiency or selective defects of carboxylase, but probably alterations of membrane receptors or cytoplasmatic transfers, that are necessary for the function of Vitamin K, are involved.

Diagnostic and prognostic value of alpha-fetoprotein, des-γ-carboxy prothrombin and squamous cell carcinoma antigen immunoglobulin M complexes in hepatocellular carcinoma.

None of the three biomarkers (AFP, DCP, SCCA-IgM Cs) is optimal and should be measured simultaneously and in combination with imaging techniques to increase the sensitivity, specificity, diagnostic accuracy and to make a reliable prognosis.

Des-γ-Carboxy (Abnormal) Prothrombin as a Serum Marker of Primary Hepatocellular Carcinoma

Levels of the abnormal prothrombin were low in patients with chronic active hepatitis or metastatic carcinoma involving the liver, and undetectable in normal subjects, while Serum α-fetoprotein levels correlated poorly with abnormal-prothrom bin levels.

Des‐gamma carboxyprothrombin can differentiate hepatocellular carcinoma from nonmalignant chronic liver disease in american patients

Evaluated whether DCP is more sensitive and specific than AFP for differentiating HCC from nonmalignant chronic liver disease in a cohort of American patients from a single referral center found it to be so, and the role of DCP in early HCC is underway.

α-fetoprotein and ultrasonography screening for hepatocellular carcinoma

Pathology assessment of liver explants in living-donor transplantation programs will provide more precise and reliable information regarding the value of AFP and US as HCC screening tools.

Frequency of Elevated Hepatocellular Carcinoma (HCC) Biomarkers in Patients With Advanced Hepatitis C

Mild–moderate elevations in total AFP and DCP but not in AFP-L3 occur frequently in patients with chronic hepatitis C and advanced fibrosis, are related to factors other than HCC, and are poor predictors of HCC.

Des-gamma-carboxy (abnormal) prothrombin as a serum marker of primary hepatocellular carcinoma.

Levels of the abnormal prothrombin were low in patients with chronic active hepatitis or metastatic carcinoma involving the liver, and undetectable in normal subjects, and may be useful in the laboratory diagnosis of primary hepatocellular carcinoma.