Abstract

Objectives:To investigate the efficacy of combined detection of 5 serological tumor markers including macrophage migration inhibitory factor (MIF) and abnormal prothrombin (PIVKA-II) in the early diagnosis of primary liver cancer.Methods:A total of 90 patients with suspected primary liver cancer admitted to our hospital from January 2016 to May 2017 were selected as the research subjects. All patients were examined by imaging and histopathology. Enzyme-linked immunosorbent assay (ELISA) was used to detect serum MIF, GP73 and PIVKA-II. Automatic electrochemiluminescence immunoassay system was used to detect serum AFP and AFP-L3. The diagnostic value of single and combined detection of five serological tumor markers for primary liver cancer was compared and analyzed.Results:Of the 90 suspected patients with primary liver cancer, thirty-seven were excluded and 53 were confirmed. From serum MIF diagnosis, fifty-three patients had positive results for primary liver cancer, of which eight had false positive results, with a sensitivity of 84.91%, a specificity of 78.38%, and an accuracy of 82.22%, respectively. From serum GP73 diagnosis, fifty-six patients had positive results for primary liver cancer, of which 10 had false positive results, with a sensitivity of 86.79%, a specificity of 72.97%, and an accuracy of 81.11%, respectively. From serum PIVKA-II diagnosis, 48 patients had positive results for primary liver cancer, of which seven had false positive results, with the sensitivity of 77.36%, the specificity of 81.08%, and the accuracy of 78.89%, respectively. From serum AFP-L3 diagnosis, fifty-two patients had positive results for primary liver cancer, of which nine had false positive results, with a sensitivity of 81.13%, a specificity of 75.68%, and an accuracy of 78.89% respectively. From serum AFP diagnosis, 57 patients had positive results for primary liver cancer, of which seven had false positive results, with a sensitivity of 83.02%, the specificity of 81.08%, and an accuracy of 82.22%, respectively. From the combined diagnosis of 5 serological tumor markers, fifty-three patients had positive results for primary liver cancer, of which one had a false positive result, with a sensitivity of 98.11%, a specificity of 97.30%, and an accuracy of 97.78%, respectively. Combined diagnosis has significantly higher sensitivity, specificity and accuracy than a single diagnosis (P<0.05).Conclusion:Serum MIF, GP73, PIVKA-II, AFP-L3 and AFP all have certain diagnostic value for primary liver cancer; the combined detection of five serological tumor markers can significantly improve the sensitivity, specificity and accuracy of the diagnosis of primary liver cancer, with higher diagnostic value.

Highlights

  • Primary liver cancer is characterized by “the most difficult to find, the most difficult to diagnose, the most difficult to treat, the fastest progress, and having the worst prognosis”.Pak J Med Sci September - October 2021 Vol 37 No 5 www.pjms.org.pk 1456Currently, diagnosing primary liver cancer in clinic practices mainly depends on imaging and pathological examinations

  • Serum macrophage migration inhibitory factor (MIF), Golgi protein 73 (GP73), abnormal prothrombin, alpha-fetoprotein (AFP) and lentil lectin-reactive alpha-fetoprotein-L3 (AFP-L3), as detection indicators in clinical practices, have certain diagnostic value for the early diagnosis of primary liver cancer.[2,3,4]

  • A total of 90 patients with suspected primary liver cancer admitted to our hospital from January 2016 to May 2017 were selected as the subjects, and all underwent imaging and histopathological examinations

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Summary

Introduction

Primary liver cancer is characterized by “the most difficult to find, the most difficult to diagnose, the most difficult to treat, the fastest progress, and having the worst prognosis”.Pak J Med Sci September - October 2021 Vol 37 No 5 www.pjms.org.pk 1456Currently, diagnosing primary liver cancer in clinic practices mainly depends on imaging and pathological examinations. The vast majority of patients with liver cancer are in the middle and advanced stages when diagnosed, lack effective treatment, and have a poor prognosis.[1,2] it is important to find and investigate diagnostic indicators with enhanced sensitivity or specificity. Serum macrophage migration inhibitory factor (MIF), Golgi protein 73 (GP73), abnormal prothrombin (protein induced by vitamin K absence or antagonist-II, PIVKA-II), alpha-fetoprotein (AFP) and lentil lectin-reactive alpha-fetoprotein-L3 (AFP-L3), as detection indicators in clinical practices, have certain diagnostic value for the early diagnosis of primary liver cancer.[2,3,4] There have been studies of using a single one for detection, as well as combining 2 or three for detection, but whether combining 5 to improve sensitivity, specificity, and accuracy remains to be studied. The levels of MIF, GP73, PIVKA-II, AFP-L3 and AFP in serum were examined, aiming to investigate its application value in diagnosing primary liver cancer and provide a new direction for the clinical diagnosis and treatment of primary liver cancer

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