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Utility of serum des-gamma-carboxyprothrombin in the diagnosis of hepatocellular carcinoma among Nigerians, a case–control study

机译:血清des-γ-羧基凝血酶原在尼日利亚人肝细胞癌诊断中的应用

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Background Hepatocellular Carcinoma (HCC) is a common malignancy occurring globally but with a dismal prognosis. Des-gamma-carboxyprothrombin (DCP) has been reported to be more sensitive and specific than Alpha-fetoprotein (AFP) in the diagnosis of HCC among the White population. Its efficacy among the Black population is yet to be established. The aim of this study therefore, was to determine the relative sensitivity and specificity of des-gamma-carboxyprothrombin and alpha-fetoprotein in the diagnosis of hepatocellular carcinoma in a cohort of Nigerian patients presenting at a single referral centre. Methods Cross-sectional case–control study was carried out using 62 HCC patients and 57 controls with benign liver diseases including chronic hepatitis and compensated liver cirrhosis. Both DCP and AFP were tested using enzyme immunoassay methods. Results Sixty-nine percent of the HCC patients presented with tumour sizes >5?cm while 31?% presented with tumour sizes 3-5?cm. No patient presented with tumour sizes 140mAU/ml. Similarly, the sensitivity and specificity of AFP were 62.9?% and 93.3?% at an ROC - derived optimum cut-off level of 18mAU/ml. The area under the receiver operating characteristic curve (AUROC) for DCP was 0.99 and was significantly larger than that of AFP which was 0.85 (p? Conclusion In conclusion, the utility of DCP for the diagnosis of HCC among Nigerian patients was higher than that of AFP for large tumours with diameter ≥3?cm.
机译:背景肝细胞癌(HCC)是全球常见的恶性肿瘤,但预后不良。据报道,在白人人群中,Des-γ-羧基凝血酶原(DCP)比甲胎蛋白(AFP)更敏感,更特异性。它在黑人人群中的功效尚未确定。因此,本研究的目的是确定在单个转诊中心就诊的尼日利亚患者队列中,des-γ-羧基凝血酶原和α-甲胎蛋白在肝细胞癌诊断中的相对敏感性和特异性。方法对62例HCC患者和57例患有良性肝病(包括慢性肝炎和代偿性肝硬化)的对照进行横断面病例对照研究。 DCP和AFP均使用酶免疫法进行了测试。结果69%的HCC患者的肿瘤大小> 5?cm,而31%的肿瘤大小为3-5?cm。没有患者出现肿瘤大小为140mAU / ml。同样,在ROC推导的18mAU / ml的最佳临界水平下,AFP的敏感性和特异性分别为62.9%和93.3%。 DCP的接受者工作特征曲线下面积(AUROC)为0.99,显着大于AFP的0.85(p?结论)总之,DCP在尼日利亚患者中诊断HCC的效用要高于DCP。 AFP适用于直径≥3?cm的大肿瘤。

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