Artificial neural network models for early diagnosis of hepatocellular carcinoma using serum levels of α-fetoprotein, α-fetoprotein-L3, des-γ-carboxy prothrombin, and Golgi protein 73.

Bo Li,Xiaoxi Li,Tongsheng Guo,Yuanli Mao,Boan Li,Lin Chen,Jing Zhao,Xiaohan Li,Zhiqiang Sun

doi:10.18632/oncotarget.19298

Abstract

More than 70% of hepatocellular carcinoma (HCC) cases develop as a consequence of liver cirrhosis (LC). Here we have evaluated the diagnostic potential of four serum biomarkers, and developed models for HCC diagnosis and differentiation from LC patients. Serum levels of α-fetoprotein (AFP), AFP-L3, des-γ-carboxy prothrombin (DCP), and Golgi protein 73 (GP73) were analyzed in 114 advanced HCC patients, 81 early stage HCC patients, and 152 LC patients. Multilayer perceptron (MLP) and radial basis function (RBF) neural networks were used to construct the diagnostic models. Using all stages, HCC diagnostic models had a higher sensitivity (>70%) than the individual serum biomarkers, whereas only early stage HCC diagnostic models had a higher specificity (>80%). The early stage HCC diagnostic models could not be used as HCC screening tools due to their low sensitivity (about 40%). These results suggest that a combination of the two models might be used as a screening tool to distinguish early stage HCC patients from LC patients, thus improving prevention and treatment of HCC.

Highlights

Liver cancer is the sixth most common cancer throughout the world, but it is the third leading cause of cancer-related death due to its very poor prognosis
The data indicated that male patients were at a higher risk to develop hepatocellular carcinoma (HCC), and liver cirrhosis (LC) patients had a worse liver synthesis function compared with HCC patients
Some studies have suggested that the also recommend that α-fetoprotein (AFP)-L3/AFP ratio might be more helpful in diagnosis and prognosis of HCC than the AFP-L3 values [31, 32]

Summary

Introduction

Liver cancer is the sixth most common cancer throughout the world, but it is the third leading cause of cancer-related death due to its very poor prognosis. Hepatocellular carcinoma (HCC) is the major histological subtype of liver cancer. More than 60% of patients are diagnosed with late-stage disease after metastasis has occurred [5], resulting in an overall 5-year survival rate of < 16% [6]. If appropriate treatments are performed in early stages, the 5-year survival rates of HCC patients exceed 75%, highlighting the need to diagnose HCC at early stages in order to achieve the greatest possibility of curative treatment [7]. According to the American Association for the Study of Liver Diseases (AASLD) practice guidelines, curative treatment can be performed in the early stage of HCC (BCLC 0-A), while in the advanced stages (BCLC B-D), only palliative or symptomatic treatments are available [8]

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