title: Discriminant function based on serum analytes differentiates hepatocarcinoma from secondary liver neoplasia.
abstract: Hepatocellular carcinoma (HC) is often difficult to distinguish from secondary liver neoplasia (SLN) by physical and imaging diagnostic procedures alone. To this aim we have extended and improved a laboratory approach based on a serum lactate dehydrogenase isoenzyme ratio (LD4:LD5) by adding the carcinoembryonic antigen: alpha-fetoprotein ratio, alkaline phosphatase, and serum iron concentrations to obtain a highly efficient discriminant function. In two successive cohorts, for a total of 102 patients, all histologically diagnosed, with a prevalence of HC vs SLN of 3:1, we correctly classified 96% of cases (100% of SLN cases). Subsequent verification with the jackknife reallocation statistical algorithm confirmed these results. In conclusion, this discriminant function based on simple laboratory assays of a few analytes is an important tool in solving a diagnostic dilemma in cases of liver neoplasia.
authors.affiliation: Dipartimento di Biochimica e Biotecnologie Mediche, Facoltà di Medicina e Chirurgia, Università di Napoli Federico II, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Castaldo
authors.forename: G
authors.initials: G
authors.lastname: Oriani
authors.forename: L
authors.initials: L
authors.lastname: Cimino
authors.forename: M
authors.initials: M
authors.lastname: Topa
authors.forename: G
authors.initials: G
authors.lastname: Budillon
authors.forename: F
authors.initials: F
authors.lastname: Salvatore
authors.forename: L
authors.initials: L
authors.lastname: Sacchetti
mesh_terms: D000469:Alkaline Phosphatase / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006801:Humans; D007501:Iron / Q000097:blood; D007527:Isoenzymes; D007770:L-Lactate Dehydrogenase / Q000097:blood; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis / Q000556:secondary*; D012372:ROC Curve; D000509:alpha-Fetoproteins / Q000032:analysis
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; D007527:Isoenzymes; D000509:alpha-Fetoproteins; D007501:Iron; D007770:L-Lactate Dehydrogenase; D000469:Alkaline Phosphatase