Serum insulin-like growth factor-II and alpha-fetoprotein as tumor markers of hepatocellular carcinoma.
To evaluate the diagnostic application of serum insulin-like growth factor-II (IGF-II) and alpha-fetoprotein (AFP) levels in hepatocellular carcinoma (HCC), IGF-II and AFP were determined in 100 cirrhotic patients with HCC, 100 sex- and age-matched patients with cirrhosis alone and 50 healthy controls. The results indicated that IGF-II and AFP levels in patients with HCC were higher than in those with cirrhosis alone (p = 0.0001). There is an inverse correlation between IGF-II and (log)AFP (r = -0.410, p = 0.0001) in patients with HCC. Multivariate analysis indicated that IGF-II and AFP were closely associated, in a dose-related fashion, with the presence of HCC. Receiver operating characteristic curves were used to determine the optimal cutoff values of IGF-II (4.5 mg/g prealbumin) and AFP (100 ng/ml), respectively. Both IGF-II and AFP show a high specificity and positive likelihood ratio. The sensitivity was 42.0% for IGF-II and 73.0% for AFP. Determination of both markers in parallel significantly increased the diagnostic accuracy (96.5%) and sensitivity (97.9%), with a high specificity (95.1%) and positive likelihood ratio (19.9). In conclusion, IGF-II and AFP may be used as complementary tumor markers to discriminate HCC from cirrhosis.
Tsai
J F
JF
Department of Internal Medicine, Kaohsiung Medical University College of Medicine, Kaohsiung, Taiwan, ROC. jftsai@cc.kmu.edu.tw
Jeng
J E
JE
Chuang
L Y
LY
You
H L
HL
Ho
M S
MS
Lai
C S
CS
Wang
L Y
LY
Hsieh
M Y
MY
Chen
S C
SC
Chuang
W L
WL
Lin
Z Y
ZY
Yu
M L
ML
Dai
C Y
CY
D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D007335:Insulin-Like Growth Factor II / Q000032:analysis*; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012307:Risk Factors; D000509:alpha-Fetoproteins / Q000032:analysis*
D014408:Biomarkers, Tumor; D000509:alpha-Fetoproteins; D007335:Insulin-Like Growth Factor II