Abstract
We conducted a comprehensive analysis to evaluate clinical utility of decarboxylation prothrombin combined with α-fetoprotein (AFP) for diagnosing primary hepatocellular carcinoma (HCC). Systematical searches were performed in PubMed, Web of Science, China National Knowledge Internet, and Wangfang databases. The bivariate random-effect model was used to calculate the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood, diagnostic odds ratio (DOR), and summary area under the curve (AUC). Fourteen studies were included in the meta-analysis. For decarboxylation prothrombin, the overall pooled parameters are as follows: sensitivity: 79% (95% confidence interval (CI): 74–84%), specificity: 91% (95%CI: 87–93%), PLR: 8.42 (95%CI: 5.79–12.23), negative likelihood ratio (NLR): 0.23 (95%CI: 0.17–0.30), DOR: 37.09 (95%CI: 21.37–64.36), summary AUC: 0.92 (95%CI: 0.89–0.94); for combined diagnostic, the overall pooled parameters were as follows: sensitivity: 91% (95%CI: 85–95%), specificity: 83% (95%CI: 74–89%), PLR: 5.26 (95%CI: 3.53–7.83), NLR: 0.11 (95%CI: 0.07–0.18), DOR: 47.14 (95%CI: 30.09–73.85), summary AUC: 0.94 (95%CI: 0.91–0.95). The serum decarboxylation prothrombin showed a relatively higher diagnostic specificity for primary HCC and decarboxylation prothrombin combined with AFP exhibited can improve sensitivity for HCC than any of the biomarkers alone.
Highlights
The hepatocellular carcinoma (HCC) is the fifth most common cancer in men and seventh in women (17.4 and 6.7 per 100000 persons per year, respectively), and ∼750 thousand new cases were diagnosed each year around the world [1]
HCC mostly occurs in people with cirrhosis of the liver, and so risk factors generally include factors which cause chronic liver disease that may lead to cirrhosis: chronic viral hepatitis, alcohol abuse, aflatoxin, non-alcoholic steatohepatitis, α1-antitrypsin deficiency, and so on [3]
This is the first meta-analysis to evaluate the clinical utility of decarboxylation prothrombin combined with as α-fetoprotein (AFP) for diagnosing primary HCC
Summary
The hepatocellular carcinoma (HCC) is the fifth most common cancer in men and seventh in women (17.4 and 6.7 per 100000 persons per year, respectively), and ∼750 thousand new cases were diagnosed each year around the world [1]. Seventy percent of all new HCCs worldwide occur in Asia, with patients in the People’s Republic of China accounting for 55% of liver cancer deaths each year [2]. HCC is the leading cause of cancer-related deaths in some developing countries, with higher degree of malignancy and poor prognosis (almost without exception, those who develop HCC each year die within 12 months), and severely threatens the public health. Serum biomarkers were still commonly used for tumor c 2018 The Author(s).
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