中文English
ISSN 1001-5256 (Print)
ISSN 2097-3497 (Online)
CN 22-1108/R
Volume 40 Issue 10
Oct.  2024
Turn off MathJax
Article Contents

Efficacy of des-γ-carboxy-prothrombin in the diagnosis of hepatocellular carcinoma and its association with the clinical features of hepatocellular carcinoma

DOI: 10.12449/JCH241014
More Information
  • Corresponding author: CHAI Wengang, chaiwengang0@126.com (ORCID: 0009-0005-3935-6316)
  • Received Date: 2024-02-19
  • Accepted Date: 2024-03-11
  • Published Date: 2024-10-25
  •   Objective  To investigate the value of des-γ-carboxy-prothrombin (DCP) in hepatocellular carcinoma (HCC).  Methods  A retrospective analysis was performed for the clinical data of 179 HCC patients who were admitted to The First Hospital of Jilin University from January 2020 to July 2021, and 207 healthy controls were enrolled as normal group. Magnetic particle chemiluminescence immunoassay was used to measure the serological levels of alpha-fetoprotein (AFP) and DCP. The receiver operating characteristic (ROC) curve was plotted for each indicator measured alone or in combination, and the area under the ROC curve (AUC) was calculated to investigate the value of DCP combined with AFP versus AFP alone in the diagnosis of HCC and the diagnostic efficacy of DCP in AFP-negative patients. The Mann-Whitney U test was used for comparison of non-normally distributed continuous data between groups; the ROC curve was used to evaluate diagnostic efficiency; the Spearman correlation analysis was used to investigate the correlation of tumor markers with the pathological features of HCC.  Results  The patients with HCC had significantly higher serum levels of AFP and DCP than the normal group (Z=-9.562 and -11.678, P<0.05), and combined measurement of DCP and AFP had a better value than AFP measured alone (Z=5.309, P<0.01). DCP had certain capability in the diagnosis of AFP-negative HCC patients, with an AUC of 0.789 (P<0.000 1), a sensitivity of 61.64%, and a specificity of 86.47%. Serum DCP level was positively correlated with tumor size (r=0.546, P<0.001), TNM stage (r=0.306, P<0.001), and microvascular invasion (r=0.358,P<0.001) and was negatively correlated with the degree of tumor differentiation (r=-0.220, P<0.05).  Conclusions  The combined measurement of AFP and DCP can improve the detection rate of HCC, and DCP can be used for supplementary screening in AFP-negative HCC patients. The expression level of DCP is correlated with the clinicopathological features of HCC, including tumor size, TNM stage, microvascular invasion, and the degree of tumor differentiation.

     

  • loading
  • [1]
    SUNG H, FERLAY J, SIEGEL RL, et al. Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries[J]. CA Cancer J Clin, 2021, 71( 3): 209- 249. DOI: 10.3322/caac.21660.
    [2]
    SIEGEL RL, MILLER KD, JEMAL A. Cancer statistics, 2020[J]. CA A Cancer J Clinicians, 2020, 70( 1): 7- 30. DOI: 10.3322/caac.21590.
    [3]
    General Office of National Health Commission. Standard for diagnosis and treatment of primary liver cancer(2022 edition)[J]. J Clin Hepatol, 2022, 38( 2): 288- 303. DOI: 10.3969/j.issn.1001-5256.2022.02.009.

    国家卫生健康委办公厅. 原发性肝癌诊疗指南(2022年版)[J]. 临床肝胆病杂志, 2022, 38( 2): 288- 303. DOI: 10.3969/j.issn.1001-5256.2022.02.009.
    [4]
    HE J, CHEN WQ, SHEN HB, et al. China guideline for liver cancer screening(2022, Beijing)[J]. J Clin Hepatol, 2022, 38( 8): 1739- 1758, 1954- 1967. DOI: 10.3969/j.issn.1001-5256.2022.08.007.

    赫捷, 陈万青, 沈洪兵, 等. 中国人群肝癌筛查指南(2022, 北京)[J]. 临床肝胆病杂志, 2022, 38( 8): 1739- 1758, 1954- 1967. DOI: 10.3969/j.issn.1001-5256.2022.08.007.
    [5]
    LIEBMAN HA, FURIE BC, TONG MJ, et al. Des-gamma-carboxy(abnormal) prothrombin as a serum marker of primary hepatocellular carcinoma[J]. N Engl J Med, 1984, 310( 22): 1427- 1431. DOI: 10.1056/NEJM198405313102204.
    [6]
    DING CM, HOU JF, TAO GW, et al. Early diagnosis and screening of hepatocellular carcinoma[J/OL]. Chin J Hepatic Surg(Electronic Edition), 2023, 12( 1): 22- 28. DOI: 10.3877/cma.j.issn.2095-3232.2023.01.005.

    丁成明, 侯嘉丰, 陶光伟, 等. 肝细胞癌早期诊断和筛查[J/OL]. 中华肝脏外科手术学电子杂志, 2023, 12( 1): 22- 28. DOI: 10.3877/cma.j.issn.2095-3232.2023.01.005.
    [7]
    YUAN LW, TANG W, ZHOU JP, et al. Quantitative measurement of des-γ-carboxy-prothrombin in cancerous and non-cancerous liver tissue and its role in hepatocellular carcinoma[J]. World Chin J Dig, 2006, 14( 1): 45- 49. DOI: 10.3969/j.issn.1009-3079.2006.01.009.

    袁联文, 唐伟, 周建平, 等. 肝癌组织中脱-γ-羧基凝血酶原的测定及意义[J]. 世界华人消化杂志, 2006, 14( 1): 45- 49. DOI: 10.3969/j.issn.1009-3079.2006.01.009.
    [8]
    SHIMADA M, YAMASHITA Y, HAMATSU T, et al. The role of des-gamma-carboxy prothrombin levels in hepatocellular carcinoma and liver tissues[J]. Cancer Lett, 2000, 159( 1): 87- 94. DOI: 10.1016/s0304-3835(00)00539-5.
    [9]
    YUEN MF, LAI CL. Serological markers of liver cancer[J]. Best Pract Res Clin Gastroenterol, 2005, 19( 1): 91- 99. DOI: 10.1016/j.bpg.2004.10.003.
    [10]
    FUJIYAMA S, MORISHITA T, SAGARA K, et al. Clinical evaluation of plasma abnormal prothrombin(PIVKA-II) in patients with hepatocellular carcinoma[J]. Hepato-gastroenterology, 1986, 33( 5): 201- 205. DOI: 10.1007/BF02560343.
    [11]
    UEHARA S, GOTOH K, HANDA H, et al. Distribution of the heterogeneity of des-γ-carboxyprothrombin in patients with hepatocellular carcinoma[J]. J Gastro And Hepatol, 2005, 20( 10): 1545- 1552. DOI: 10.1111/j.1440-1746.2005.03899.x.
    [12]
    SEKIYA C, KOHDA H, HASEBE C, et al. Characteristics of the PIVKA-II found in hepatocellular carcinoma, investigation using monoclonal antibodies MU-3 and 19B7[J]. Int Hepatol Commun, 1994, 2( 5): 277- 284. DOI: 10.1016/0928-4346(94)90063-9.
    [13]
    OHHIRA M, OHTAKE T, SAITO H, et al. Increase of serum des-gamma-carboxy prothrombin in alcoholic liver disease without hepatocellular carcinoma[J]. Alcohol Clin Exp Res, 1999, 23( 4 Suppl): 67S- 70S. DOI: 10.1111/j.1530-0277.1999.tb04537.x.
    [14]
    MURATA K, SUZUKI H, OKANO H, et al. Hypoxia-induced des-gamma-carboxy prothrombin production in hepatocellular carcinoma[J]. Int J Oncol, 2010, 36( 1): 161- 170.
    [15]
    SUZUKI H, MURATA K, GOTOH T, et al. Phenotype-dependent production of des-γ-carboxy prothrombin in hepatocellular carcinoma[J]. J Gastroenterol, 2011, 46( 10): 1219- 1229. DOI: 10.1007/s00535-011-0432-8.
    [16]
    HAO X, FAN R, HOU JL. Early warning and accurate screening for the high-risk population of hepatocellular carcinoma[J]. J Clin Hepatol, 2022, 38( 3): 499- 504. DOI: 10.3969/j.issn.1001-5256.2022.03.002.

    郝新, 樊蓉, 侯金林. 原发性肝癌高危人群的早期预警和精准筛查[J]. 临床肝胆病杂志, 2022, 38( 3): 499- 504. DOI: 10.3969/j.issn.1001-5256.2022.03.002.
    [17]
    BEST J, BECHMANN LP, SOWA JP, et al. GALAD score detects early hepatocellular carcinoma in an international cohort of patients with nonalcoholic steatohepatitis[J]. Clin Gastroenterol Hepatol, 2020, 18( 3): 728- 735. e 4. DOI: 10.1016/j.cgh.2019.11.012.
    [18]
    NAN Y, GARAY OU, LU X, et al. Early-stage hepatocellular carcinoma screening in patients with chronic hepatitis B in China: a cost-effectiveness analysis[J]. J Comp Eff Res, 2024, 13( 4): e230146. DOI: 10.57264/cer-2023-0146.
    [19]
    LOGLIO A, IAVARONE M, FACCHETTI F, et al. The combination of PIVKA-II and AFP improves the detection accuracy for HCC in HBV Caucasian cirrhotics on long-term oral therapy[J]. Liver Int, 2020, 40( 8): 1987- 1996. DOI: 10.1111/liv.14475.
    [20]
    KIM HS, PARK JW, JANG JS, et al. Prognostic values of alpha-fetoprotein and protein induced by vitamin K absence or antagonist-II in hepatitis B virus-related hepatocellular carcinoma: A prospective study[J]. J Clin Gastroenterol, 2009, 43( 5): 482- 488. DOI: 10.1097/MCG.0b013e318182015a.
    [21]
    FENG HL, LI BL, LI Z, et al. PIVKA-II serves as a potential biomarker that complements AFP for the diagnosis of hepatocellular carcinoma[J]. BMC Cancer, 2021, 21( 1): 401. DOI: 10.1186/s12885-021-08138-3.
  • 加载中

Catalog

    通讯作者: 陈斌, bchen63@163.com
    • 1. 

      沈阳化工大学材料科学与工程学院 沈阳 110142

    1. 本站搜索
    2. 百度学术搜索
    3. 万方数据库搜索
    4. CNKI搜索

    Figures(3)  / Tables(2)

    Article Metrics

    Article views (162) PDF downloads(32) Cited by()
    Proportional views
    Related

    /

    DownLoad:  Full-Size Img  PowerPoint
    Return
    Return