The value of serum tissue polypeptide specific antigen in the diagnosis of hepatocellular carcinoma.
BACKGROUND
Tissue polypeptide specific antigen (TPS) recently was introduced as an indicator of cell proliferation in various tumors. The authors investigated the value of serum TPS as a complement to alpha-fetoprotein (AFP) in the detection of hepatocellular carcinoma (HCC) in Chinese patients.


METHODS
Serum TPS and AFP levels were measured by monoclonal immunoradiometric assay in 85 subjects (52 males and 33 females): 26 with HCC, 30 with chronic hepatitis (CH), and 29 healthy controls.


RESULTS
Patients with HCC had significantly higher TPS levels compared with healthy controls (P < 0.05). However, the difference between the HCC and CH groups was not significant (P = 0.18). The sensitivity and specificity of TPS were 73.1% and 71.2%, respectively, with a cutoff value of 164 U/L for HCC diagnosis. TPS had lower discriminatory power compared with AFP (72.1% vs. 79.2%). In addition, TPS had a much lower specificity compared with AFP (89.1%). Combining the cutoff values for serum TPS and AFP levels in a pessimistic prognostic rule increased the sensitivity by 11.6% from 69.2% using serum AFP levels alone, but reduced the diagnostic power by 3.7% to 75.5% due to an 18.9% decrease in specificity to 70.2%.


CONCLUSIONS
Using TPS alone offers no advantage over AFP for the diagnosis of HCC in Chinese patients. In conjunction with AFP, TPS reduced the false-negative rate. However, the clinical utility of the combined prognostic rule is limited due to the poor discriminatory power of TPS for HCC and CH. Therefore, the use of serum TPS levels in the detection of HCC is not recommended.
Tu
D G
DG
Department of Nuclear Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, Republic of China.
Wang
S T
ST
Chang
T T
TT
Chiu
N T
NT
Yao
W J
WJ
D000328:Adult; D000368:Aged; D000951:Antigens, Neoplasm / Q000097:blood*; D044466:Asian People; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000276:immunology*; D016022:Case-Control Studies; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000276:immunology*; D008297:Male; D008875:Middle Aged; D010455:Peptides / Q000097:blood*; D011237:Predictive Value of Tests; D012372:ROC Curve; D012680:Sensitivity and Specificity; D000509:alpha-Fetoproteins / Q000378:metabolism*
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D010455:Peptides; D000509:alpha-Fetoproteins; C089984:tissue polypeptide specific antigen