Impact of etiology of chronic liver disease on hepatocellular carcinoma biomarkers.

IF 1.9

Cancer biomarkers : section A of Disease markers Pub Date : 2018-02-14 DOI:10.3233/CBM-170551

Gabriele Ricco, Daniela Cavallone, Chiara Cosma, Gian Paolo Caviglia, Filippo Oliveri, Alessandra Biasiolo, Maria Lorena Abate, Mario Plebani, Antonina Smedile, Ferruccio Bonino, Patrizia Pontisso, Maurizia Rossana Brunetto

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引用次数: 22

Abstract

Background: The role of serum biomarkers in the surveillance of hepatocellular carcinoma (HCC) is controversial.

Objective: We assessed the diagnostic performances of alpha-fetoprotein (AFP) and protein-induced by vitamin-K-absence/antagonist-II (PIVKA-II) in 388 cirrhotic patients with chronic liver disease (CLD).

Methods: Biomarkers were quantified by automated chemiluminescent-enzyme-immunoassays (Fujirebio, Tokyo, Japan) at HCC diagnosis in 258 patients (204 males; median age 66.9 years) and in 130 cirrhotics without HCC (104 males; median-age 60.6 years). CLD etiology in HCC/non-HCC was CHB in 48/35, CHC in 126/56 and Non-Viral in 84/39.

Results: Overall AUROC values for AFP and PIVKA-II were 0.698 (95%CI = 0.642-0.753, P< 0.001) and 0.780 (95%CI = 0.730-0.831, P< 0.001). AFP/PIVKA-II AUROC (95%CI) were: 0.822 (0.728-0.915)/0.833 (0.739-0.926) in CHB, 0.648 (0.560-0.736)/0.732 (0.650-0.814) in CHC; 0.640 (0.540-0.740)/0.806 (0.722-0.889) in Non-Viral-CLD. AFP/PIVKA-II diagnostic accuracy was 40.5-59.8%/62.7-73.5% and combining both markers 78.2% for CHB, 77% for Non-Viral-CLD and 75% for CHC. AFP correlated with ALT in HCC patients with CHC (ρ= 0.463/P< 0.001) and Non-Viral CLD (ρ= 0.359/P= 0.047), but not in CHB (treated with antivirals). PIVKA-II correlated with tumour size independently of CLD-etiology (P< 0.001) and AFP in CHB patients only (P= 0.007).

Conclusion: The diagnostic performance of AFP and PIVKA-II is significantly influenced by the etiology and activity of CLD; their combination provides a better diagnostic accuracy.

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慢性肝病病因学对肝细胞癌生物标志物的影响

背景:血清生物标志物在肝细胞癌(HCC)监测中的作用存在争议。目的:评估甲胎蛋白(AFP)和维生素k缺失/拮抗剂- ii (PIVKA-II)诱导蛋白在388例肝硬化合并慢性肝病(CLD)患者中的诊断价值。方法:258例HCC诊断患者(204例男性;中位年龄66.9岁)和130例无HCC的肝硬化患者(104例男性;中位年龄60.6岁)。HCC/非HCC的CLD病因为CHB(48/35)、CHC(126/56)和非病毒性(84/39)。结果:AFP和PIVKA-II的总AUROC值分别为0.698 (95%CI = 0.642 ~ 0.753, P< 0.001)和0.780 (95%CI = 0.730 ~ 0.831, P< 0.001)。CHB组AFP/PIVKA-II AUROC (95%CI)分别为0.822 (0.728-0.915)/0.833 (0.739-0.926)，CHC组为0.648 (0.560-0.736)/0.732 (0.650-0.814);非病毒性cld为0.640(0.540-0.740)/0.806(0.722-0.889)。AFP/PIVKA-II的诊断准确率为40.5-59.8%/62.7-73.5%，两种标志物联合诊断CHB的准确率为78.2%，非病毒性cld的准确率为77%，CHC的准确率为75%。在HCC合并CHC (ρ= 0.463/P< 0.001)和非病毒性CLD (ρ= 0.359/P= 0.047)患者中，AFP与ALT相关(ρ= 0.463/P< 0.001)，但在CHB(抗病毒药物治疗)患者中，AFP与ALT无关。PIVKA-II仅与CHB患者的肿瘤大小(P< 0.001)和AFP相关(P= 0.007)，而与cld病因无关。结论:AFP和PIVKA-II的诊断效能受CLD病因和活动性的显著影响;它们的组合提供了更好的诊断准确性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Cancer biomarkers : section A of Disease markers

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