Serum Des-gamma-carboxy Prothrombin for Diagnosis of Adult Primary Cancer in Liver.

Abstract

To explore the diagnostic accuracy of serum des-gamma-carboxy prothrombin (DCP) in adult primary cancer in liver. Descriptive study. Department of Traditional Chinese Medicine, the First Affiliated Hospital, College of Medicine, Zhejing University, Hangzhou, China, from June 2016 to March 2018. A retrospective study of 1,190 cases was undertaken and all the participants were divided into Group 1 (non-cancer patients) and Group 2 (primary cancer in liver patients). The records of DCP and alpha fetoprotein (AFP) levels were extracted and compared between Group 1 and Group 2. The sensitivity, specificity, and cutoff point of DCP in Group 2 and its different histological types were calculated. The receiver operating characteristic (ROC) curves were obtained, and the areas under the receiver operating characteristic curve (AUROC) were calculated and compared in different histological types. The DCP and AFP levels in Group 2 were markedly higher than Group 1 (p <0.001). For primary cancer in liver, the sensitivity, specificity, cutoff value, and AUROC of DCP were 64.2%, 91%, 56.5 mAU/mL, and 0.807 (95% CI: 0.783- 0.832), respectively. For hepatocellular carcinoma (HCC), the sensitivity, specificity, cutoff value, and AUROC of DCP were 69.3%, 92.2%,60.5mAU/mL, and 0.846 (95% CI: 0.817-0.875), respectively. For intrahepatic cholangiocarcinoma (ICC), the sensitivity, specificity, cutoff value, and AUROC of DCP were 13.6%, 93.2%, 76.5 mAU/mL, and 0.512 (95% CI: 0.439- 0.586), respectively. For combined hepatocellular-cholangiocarcinoma (cHCC-CC), the sensitivity, specificity, cutoff value, and AUROC of DCP were 66.7%, 81.5%, 40.5 mAU/mL, and 0.737 (95% CI: 0.585-0.888), respectively. DCP could be considered not only for surveillance and diagnosis of primary cancer in liver, but also for differential diagnosis of its different histological types.