Clinical value of serum Glycan-Test in the diagnosis of hepatitis B virus-related hepatocellular carcinoma

Objective To investigate the clinical value of the oligosaccharide chain detection kit Glycan-Test( G-Test,fluorescent capillary electrophoresis) in assisting the diagnosis of hepatitis B virus( HBV)-related hepatocellular carcinoma( HCC). Methods A total of310 serum samples were collected from the patients who attended Beijing YouAn Hospital from August 2017 to June 2018,among which there were 170 samples of HBV-related HCC( HCC group),50 samples of hepatitis B cirrhosis( liver cirrhosis group),85 samples of chronic hepatitis B( hepatitis group),and 5 samples of other malignant tumors of visceral organs. The relative concentration of serum oligosaccharide chain was measured,and the sensitivity,specificity,overall coincidence rate,positive predictive value,and negative predictive value of G-Test in clinical diagnosis were calculated and analyzed. A methodological comparison was performed for G-Test and serum alpha-fetoprotein( AFP). The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups,and the Dunn's multiple comparison test was used for further comparison between two groups; the chi-square test was used for comparison of categorical data between two groups. The receiver operating characteristic( ROC) curve was used to evaluate diagnostic efficiency,and the logistic regression model was used to establish a combined diagnostic model of G-Test and AFP. The Z test was used for comparsion of area under ROC curve. Results The HCC group had a significantly higher level of G-Test than the hepatitis group [6. 46( 5. 73-7. 07) vs 3. 38( 2. 85-4. 18),H =107. 9,P <0. 001]and the liver cirrhosis group[6. 46( 5. 73-7. 07) vs 3. 99( 3. 13-5. 21),H = 104. 2,P < 0. 001].The HCC group had a significantly higher AFP level than the hepatitis group [0. 77( 0. 45-1. 77) log10 ng/ml vs 0. 58( 0. 41-0. 89) log10 ng/ml,H = 33. 65,P = 0. 025]. G-Test had a sensitivity of 83. 53%,a specificity of 74. 29%,an overall coincidence rate of 79. 36%,a positive predictive value of 79. 78%,and a negative predictive value of 78. 79%. G-Test alone had a significantly larger AUC than AFP alone( 0. 846 vs 0. 611,Z = 5. 795,P < 0. 001),and G-Test combined with AFP had an AUC of 0. 870,which was significantly larger than that of G-Test alone( Z = 2. 523,P = 0. 012) or AFP alone( Z = 6. 943,P < 0. 001). There were significant differences in the detection rates of G-Test and AFP between the early-stage group and the advanced group( χ2= 26. 441、38. 379,all P < 0. 001). At the negative cut-off values of < 20, < 200,and < 400 ng/ml for AFP,G-Test had a detection rate of 86. 24%,85. 93%,and 85. 31%,respectively,in HCC patients with negative AFP. Conclusion G-Test has good sensitivity and specificity and a certain clinical value in assisting the diagnosis of HCC,and G-Test combined with AFP has better diagnostic efficiency.