Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein improves diagnostic accuracy for hepatocellular carcinoma

作     者：Han Ah Lee Yoo Ra Lee Young-Sun Lee Young Kul Jung Ji Hoon Kim Hyunggin An Hyung Joon Yim Yoon Tae Jeen Jong Eun Yeon Kwan Soo Byun Yeon Seok Seo 

作者机构：Department of Internal MedicineKorea University College of MedicineSeoul 02841South Korea Department of BiostatisticsKorea University Anam HospitalSeoul 02841South Korea 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2021年第27卷第28期

页      面：4687-4696页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Alpha-fetoprotein Lens culinaris agglutinin-reactive fraction of alphafetoprotein Protein induced by vitamin K absence or antagonist-II Hepatocellular carcinoma 

摘      要：BACKGROUND Diagnostic accuracy of various tumor markers and their combinations for hepatocellular carcinoma(HCC)was not fully *** To evaluate the diagnostic accuracy of alpha-fetoprotein(AFP),the Lens culinaris agglutinin-reactive fraction of AFP(AFP-L3),and protein induced by vitamin K absence or antagonist-II(PIVKA-II)and their combination for HCC *** Patients with newly detected liver mass or elevated serum AFP levels were considered *** AFP level,AFP-L3 fraction,and PIVKA-II level were measured at the first *** In total,622 patients were included;355 patients(57.1%)had chronic liver disease,and 208(33.4%)had liver *** was diagnosed in 160 patients(25.7%).The area under the receiver operating characteristics curves(AUROCs)of the serum AFP,AFP-L3 fraction,AFP-L3,and PIVKA-II levels for the diagnosis of HCC were 0.775,0.792,0.814,and 0.834,respectively.A novel diagnostic model was developed by classifying patients in a 1:1 ratio into training and validation *** the binary regression analysis of the training cohort,the AFP,AFP-L3 fraction,and PIVKA-II(ALPs)score was calculated as follows:ALPs score=3.8×[serum AFP level(ng/mL)×AFP-L3 fraction(%)×0.01]+0.2×PIVKA-II level(mAU/mL).The AUROC of the ALPs score for diagnosis of HCC was 0.878,significantly higher than that of serum AFP level(P0.001),AFP-L3 fraction(P0.001),PIVKA-II level(P=0.036),and AFP-L3 level(P=0.006).The optimal ALPs score cut-off was 5.3(sensitivity,85.0%,specificity 80.1%).The validation cohort showed similar *** The ALPs score calculated using serum AFP level,AFP-L3 fraction,and PIVKA-II level showed improved accuracy in HCC diagnosis.