Alpha-fetoprotein and des-gamma-carboxyprothrombin in the differential diagnosis of hepatocellular carcinoma from other liver tumors

Objective To compare the clinical utility of alpha-fetoprotein (AFP) and des-gamma-carboxyprothrombin (DCP) in diagnosing hepatocellular carcinoma (HCC) in patients with a hepatic mass. Methods From January 2015 to May 2015, 141 patients were diagnosed to have a liver tumor after imaging examinations in the Hepatobiliary Surgical General Hospital of PLA, Beijing, China. Preoperative AFP and DCP were measured using commercial assay kits. The reference standard was either pathologic or clinical diagnosis of HCC. The performance of AFP and DCP in diagnosing HCC was determined using receiver operating characteristic curve analysis. Results Of 141 patients, 98 were diagnosed to have HCC and 43 without. The levels of AFP were significantly higher in patients with HCC than those without [80.0(3.9-1 375.0)μg/L vs. 2.1(1.6-3.2)μg/L, Z=6.98, P or=20 μg/L, 69.4% and 83.7% for DCP>or=40 AU/L, respectively. The level of AFP was associated with DCP in patients with HCC (χ2=9.12, P<0.01, r=0.292) and parallel testing of AFP and DCP gave an optimal sensitivity of 79.6% with a specificity of 81.4% in diagnosing HCC. Conclusions DCP is a useful biomarker and it gave an equal performance as AFP in diagnosing HCC in patients with a liver mass in this study. Parallel testing of AFP and DCP effectively increased the diagnostic sensitivity. Although the biomarkers only marginally improved the diagnostic results, it could be useful in diagnosing HCC in individuals who had atypical imaging results. Key words: Des-gamma-carboxyprothrombin; Alpha-fetoprotein; Hepatocellular carcinoma; Liver tumor; Diagnosis