Usefulness of AFP, AFP-L3, and PIVKA-II, and their combinations in diagnosing hepatocellular carcinomaopen access
- Authors
- Park, Sang Joon; Jang, Jae Young; Jeong, Soung Won; Cho, Young Kyu; Lee, Sae Hwan; Kim, Sang Gyune; Cha, Sang-Woo; Kim, Young Seok; Cho, Young Deok; Kim, Hong Soo; Kim, Boo Sung; Park, Suyeon; Bang, Hae In
- Issue Date
- Mar-2017
- Publisher
- Lippincott Williams & Wilkins Ltd.
- Keywords
- AFP; AFP-L3; diagnostic value; hepatocellular carcinoma; PIVKA-II
- Citation
- Medicine, v.96, no.11
- Journal Title
- Medicine
- Volume
- 96
- Number
- 11
- URI
- https://scholarworks.bwise.kr/sch/handle/2021.sw.sch/7736
- DOI
- 10.1097/MD.0000000000005811
- ISSN
- 0025-7974
1536-5964
- Abstract
- Alpha-fetoprotein (AFP), Lens culinaris-agglutinin-reactive fraction of AFP (AFP-L3), and protein induced by vitamin K absence or antagonist-II (PIVKA-II) are widely used as tumor markers for the diagnosis of hepatocellular carcinoma (HCC). This study compared the diagnostic values of AFP, AFP-L3, and PIVKA-II individually and in combination to find the best biomarker or biomarker panel. Seventy-nine patients with newly diagnosed HCC and 77 non-HCC control patients with liver cirrhosis were enrolled. AFP, AFP-L3, and PIVKA-II were measured in the same serum samples using microchip capillary electrophoresis and a liquid-phase binding assay on an automatic analyzer. Receiver-operating characteristic curve analyses were also applied to all combinations of the markers. When the 3 biomarkers were analyzed individually, AFP showed the largest area under the receiver-operating characteristic curve (AUC) (0.751). For combinations of the biomarkers, the AUC was highest (0.765) for '' PIVKA- II> 40mAU/mL and AFP> 10ng/ mL.'' The combination of '' PIVKA- II> 40mAU/ mL and AFP> 10ng/ mL and AFP-L3> 10%" had worse sensitivity and lower AUC ( P= 0.001). The highest AUC of a single biomarker was highest for AFP and of a combination was '' PIVKA- II> 40mAU/ mL and AFP> 10 ng/ mL," with this also being the case when the cut-off value of AFP and AFP-L3 was changed. Alpha-fetoprotein showed the best diagnostic performance as a single biomarker for HCC. The diagnostic value of AFP was improved by combining it with PIVKA-II, but adding AFP-L3 did not contribute to the ability to distinguish between HCC and non-HCC liver cirrhosis. These findings were not altered when the cut-off value of AFP and AFP-L3 was changed.
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Collections - College of Medicine > Department of Clinical Pathology > 1. Journal Articles
- College of Medicine > Department of Internal Medicine > 1. Journal Articles
- College of Medicine > Department of Internal Medicine > 1. Journal Articles
- College of Medicine > Department of Internal Medicine > 1. Journal Articles
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