Abstract
Controversies about the combination of des-gamma-carboxyprothrombin (DCP) and alpha-fetoprotein (AFP) for hepatocellular carcinoma diagnosing still exist. Hence, we performed this updated meta-analysis to estimate the diagnostic value of DCP , AFP and DCP + AFP in HCC. In addition, we conducted a validation study to analyze the performance of the candidate makers. After a systematic literature review, 27 studies from 20 articles were identified from four major databases. The pooled sensitivity and specificity were 69% and 89%, respectively, for DCP; for AFP, they were 65% and 88%, respectively; and they were 82% and 85%, respectively, for DCP + AFP. The values of the area under the curve (AUC) for DCP, AFP, DCP + AFP, respectively, were 0.88, 0.75, and 0.90. The validation study confirmed that the performance of DCP + AFP (sensitivity = 84%, specificity = 86%; AUC = 0.887) was higher than that of DCP (sensitivity = 76%, specificity = 92%; AUC = 0.843) or AFP (sensitivity = 73%, specificity = 92%; AUC = 0.837) alone.
Highlights
Hepatocellular carcinoma (HCC) is one of the most (70–90%) frequent types of primary carcinoma of the liver and it is the third dominating cause of cancer-related mortality among men worldwide [1]
112 articles were eliminated for the following reasons: did not contain adequate data to construct a 2 × 2 table, did not contain sufficient information on the criteria used to diagnose HCC or analyzed only serum DCP and AFP alone, or they were published in non-English language periodicals
The results of this meta-analysis including 27 studies from 20 articles demonstrated that the overall sensitivity and specificity of DCP was, respectively, 69% and 89%
Summary
Hepatocellular carcinoma (HCC) is one of the most (70–90%) frequent types of primary carcinoma of the liver and it is the third dominating cause of cancer-related mortality among men worldwide [1]. Heavy alcohol drinking, nonalcoholic fatty liver disease, and smoking contribute to the occurrence and progression of HCC [2]. Serum alpha-fetoprotein (AFP) is commonly used to diagnose HCC. Owing to its low sensitivity and specificity, AFP testing alone is not recommended in diagnostic assessments of HCC [3,4,5,6,7,8,9,10]. It is used to combine with other serum or plasma tumor markers, which have been shown to have superior diagnostic abilities [3, 6, 11,12,13,14,15]
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