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protein induced by vitamin k absence or antagonist-ⅱ versus alpha-fetoprotein in the diagnosis of hepatocellular carcinoma: A systematic review with meta-analysis

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Hepatobiliary & Pancreatic Diseases International 2018年第6期17卷 487-495页

作者： Hao Xing Yi-Jie Zheng Jun Han Han Zhang Zhen-Li Li Wan-Yee Lau Feng Shen Tian Yang Department of Hepatic Surgery Eastern Hepatobiliary Surgery Hospital Naval Medical University Medical Scientific Affairs Abbott Diagnostics Faculty of Medicine The Chinese University of Hong Kong

Background: As a promising biomarker of hepatocellular carcinoma(HCC), protein induced by vitamin k absence or antagonist-ⅱ(PIVkA-Ⅱ) has been studied extensively. However, its diagnostic capability varies across HCC studies. This study aimed to compare the performance of PIVkA-Ⅱ with alpha-fetoprotein(AFP) in the diagnosis of HCC. Data sources: A systematic literature search was conducted to identify the studies from MEDLINE, Embase and Cochrane Library Databases, which were published up to December 20, 2017 to compare the diagnostic capability of PIVkA-Ⅱ and AFP for HCC. The data were pooled using random effects model. Pooled sensitivity and specificity were calculated. Summary receiver operating characteristic curve(ROC) was employed to evaluate the diagnostic accuracy of each marker. Results: Thirty-one studies were included. The pooled sensitivity(95% CI) of PIVkA-Ⅱ and AFP was 0.66(0.65–0.68) and 0.66(0.65–0.67), respectively in diagnosis of HCC; and the corresponding pooled specificity(95% CI) was 0.89(0.88–0.90) and 0.84(0.83–0.85), respectively. The area under the ROC curve(AUC) of PIVkA-Ⅱ and AFP was 0.856(0.817–0.895) and 0.770(0.728–0.811), respectively. Subgroup analysis showed that PIVkA-Ⅱ was superior to AFP in terms of the AUC for both small HCC( kA-Ⅱ is better than AFP in terms of the accuracy for diagnosing HCC, regardless of tumor size, patient ethnic group, or HCC etiology.

关键词： Hepatocellular carcinoma Meta-analyses protein induced by vitamin k absence or antagonist-ⅱ Alpha-fetoprotein

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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

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Hepatobiliary & Pancreatic Diseases International 2022年第6期21卷 559-568页

作者： Ming-Cheng Guan Wei Ouyang Si-Yu Liu Li-Yang Sun Wei-Yue Chen Xiang-Min Tong Hong Zhu Tian Yang Department of Medical Oncology the First Affiliated Hospital of Soochow UniversitySuzhou 215006China Department of Laboratory Zhejiang University Lishui HospitalLishui 323000China Department of Hepatobiliary Pancreatic 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 Province Department of Interventional RadiologyZhejiang University Lishui HospitalLishui 323000China School of Clinical Medicine Hangzhou Medical CollegeHangzhou 310059China Department of Hepatobiliary Surgery Eastern Hepatobiliary Surgery HospitalSecond Military Medical University(Navy Medical University)Shanghai 200438China

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 PkA-Ⅱ showed the best performance in diagnosing any-stage HCC with an AUC of 0.869,followed by AFP(0.763;***-Ⅱ,PkA-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,PkA-II,PkA-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.

关键词： 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

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