@article{Liu2021, 
author = {Dongming Liu and Yi Luo and Lu Chen and Liwei Chen and Duo Zuo and Yueguo Li and Xiaofang Zhang and Jing Wu and Qing Xi and Guangtao Li and Lisha Qi and Xiaofen Yue and Xiehua Zhang and Zhuoyu Sun and Ning Zhang and Tianqiang Song and Wei Lu and Hua Guo},
title = {Diagnostic value of 5 serum biomarkers for hepatocellular carcinoma with different epidemiological backgrounds: A large-scale, retrospective study},
year = {2021},
journal = {Cancer Biology & Medicine},
volume = {18},
number = {1},
pages = {256-270},
keywords = {Hepatocellular carcinoma, serum, biomarker, AFP, AFU},
url = {https://www.sciopen.com/article/10.20892/j.issn.2095-3941.2020.0207},
doi = {10.20892/j.issn.2095-3941.2020.0207},
abstract = {ObjectiveHepatocellular 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.MethodsIn 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.ResultsThe α-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.ConclusionsThe AFP/AFU combination could be used to identify NBNC-HCC from healthy controls and hepatitis-related HCC from at-risk patients.}
}