Alpha-fetoprotein,protein induced by vitamin K absence or antagonist-Ⅱ,lens culinaris agglutinin-reactive fraction of alpha-fetoprotein alone and in combination for early detection of hepatocellular carcinoma from nonalcoholic fatty liver disease:A multicenter analysis

作     者：Ming-Cheng Guan Wei Ouyang Si-Yu Liu Li-Yang Sun Wei-Yue Chen Xiang-Min Tong Hong Zhu Tian Yang Ming-Cheng Guan;Wei Ouyang;Si-Yu Liu;Li-Yang Sun;Wei-Yue Chen;Xiang-Min Tong;Hong Zhu;Tian Yang

作者机构：Department of Medical Oncologythe First Affiliated Hospital of Soochow UniversitySuzhou 215006China Department of LaboratoryZhejiang University Lishui HospitalLishui 323000China Department of HepatobiliaryPancreatic and Minimal Invasive SurgeryZhejiang Provincial People’s HospitalPeople’s Hospital of Hangzhou Medical CollegeHangzhou 310014China The Key Laboratory of Imaging Diagnosis and Minimally Invasive Interventional Research of Zhejiang ProvinceDepartment of Interventional RadiologyZhejiang University Lishui HospitalLishui 323000China School of Clinical MedicineHangzhou Medical CollegeHangzhou 310059China Department of Hepatobiliary SurgeryEastern Hepatobiliary Surgery HospitalSecond Military Medical University(Navy Medical University)Shanghai 200438China 

出 版 物：《Hepatobiliary & Pancreatic Diseases International》 (国际肝胆胰疾病杂志（英文版）)

年 卷 期：2022年第21卷第6期

页      面：559-568页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 100214[医学-肿瘤学] 10[医学] 

基　　金：the National Natural Science Foundation of China(81972726,81871949 and 82171834) Jiangsu Six Talent Peaks Project(WSN-102) 

主　　题：Hepatocellular carcinoma Nonalcoholic fatty liver disease Alpha-fetoprotein Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein Protein induced by vitamin K absence or antagonist-Ⅱ 

摘      要：Background:Current surveillance strategies for hepatocellular carcinoma(HCC)among patients with non-alcoholic fatty liver disease(NAFLD)are *** study aimed to investigate the diagnostic perfor-mance of alpha-fetoprotein(AFP),protein induced by vitamin K absence or antagonist-Ⅱ(PIVKA-Ⅱ),lens culinaris agglutinin-reactive fraction of AFP(AFP-L3),and their combinations in HCC underlying NAFLD ***:Serologic AFP,AFP-L3,and PIVKA-Ⅱ levels in NAFLD patients with and without HCC were *** receiver operating characteristic(ROC)analyses,the area under the curve(AUC),sensitivity,and specificity were obtained to evaluate the diagnostic accuracy of each biomarker and their ***:This study was conducted on 139 patients with NAFLD-HCC and 345 NAFLD *** eleva-tion of these three biomarkers was observed in patients with NAFLD-HCC compared to those in NAFLD controls(all P0.001).When they were analyzed individually,PIVKA-Ⅱ showed the best performance in diagnosing any-stage HCC with an AUC of 0.869,followed by AFP(0.763;***-Ⅱ,P0.001)and AFP-L3(0.689;***-II,P0.001).When they were analyzed in combination,AFP+PIVKA-Ⅱ yielded the highest AUC(0.906),followed by AFP+PIVKA-II+AFP-L3(0.904;***+PIVKA-Ⅱ,P=0.086),PIVKA-Ⅱ+AFP-L3(0.881;***+PIVKA-II,P0.001),and AFP+AFP-L3(0.759;***+PIVKA-II,P0.001).Similar findings were obtained in the subgroup with early-stage NAFLD-HCC,as well as the non-cirrhotic ***:These data validated the better diagnostic ability of PIVKA-II than AFP or AFP-L3 alone for diagnosing any-stage HCC among patients with NAFLD,and the combination of AFP+PIVKA-II signifi-cantly improved the diagnostic accuracy of NAFLD-HCC.