Sensitivity and specificity of des-gamma-carboxy prothrombin for diagnosis of patients with hepatocellular carcinomas varies according to tumor size.
OBJECTIVE
Serum levels of des-gamma-carboxy prothrombin (DCP) and alpha-fetoprotein (AFP) are known to be useful tumor markers for the diagnosis of hepatocellular carcinoma (HCC). The aim of this study was to examine the diagnostic efficacy of DCP and AFP in differentiating HCC from chronic liver diseases.


METHODS
We examined 1,377 HCC patients and 355 patients with chronic hepatitis or cirrhosis (non-HCC) who visited our institute and affiliated hospitals between June 1997 and September 2003.


RESULTS
The median values of DCP and AFP were 60 mAU/mL and 34 ng/mL in HCC patients, respectively, and 18 mAU/mL and 3 ng/mL in non-HCC patients, respectively. The areas under the receiver operating characteristic (ROC) curves of DCP and AFP were 0.812 and 0.887, respectively (p < 0.0001). The area under the DCP ROC curve was significantly smaller than that of AFP in tumors less than 3 cm in diameter (p < 0.0001). However, the ROC area of DCP was significantly larger than that of AFP in tumors greater than 5 cm in diameter (p < 0.0001).


CONCLUSIONS
The utility of DCP for the diagnosis of HCC was lower than that of AFP for small tumors, but higher than that of AFP for large tumors.
Nakamura
Shinichiro
S
Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
Nouso
Kazuhiro
K
Sakaguchi
Kohsaku
K
Ito
Yoichi M
YM
Ohashi
Yasuo
Y
Kobayashi
Yoshiyuki
Y
Toshikuni
Nobuyuki
N
Tanaka
Hironori
H
Miyake
Yasuhiro
Y
Matsumoto
Eiji
E
Shiratori
Yasushi
Y
D000368:Aged; D015415:Biomarkers / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006521:Hepatitis, Chronic / Q000097:blood / Q000175:diagnosis; D006801:Humans; D007124:Immunoenzyme Techniques; D008103:Liver Cirrhosis / Q000097:blood / Q000175:diagnosis; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods; D011498:Protein Precursors / Q000097:blood*; D011516:Prothrombin; D012372:ROC Curve; D012720:Severity of Illness Index; D000509:alpha-Fetoproteins / Q000378:metabolism
D015415:Biomarkers; D014408:Biomarkers, Tumor; D011498:Protein Precursors; D000509:alpha-Fetoproteins; C008208:acarboxyprothrombin; D011516:Prothrombin