Novel method to measure serum levels of des-gamma-carboxy prothrombin for hepatocellular carcinoma in patients taking warfarin: a preliminary report.
Des-gamma-carboxy prothrombin (DCP) is a useful tumor marker for hepatocellular carcinoma (HCC), but its utility is limited in patients taking vitamin K antagonists. We evaluated the NX-DCP ratio, a newly developed method to measure serum DCP, for its ability to identify DCP elevation induced by HCC in this patient subpopulation. Conventional DCP measurements and the NX-DCP ratio were compared in patients with and without HCC, all of whom were taking the vitamin K antagonist warfarin. We found no differences in conventional DCP measurements between patients with and without HCC due to warfarin treatment. In contrast, the NX-DCP ratio was significantly higher in patients with HCC; the NX-DCP ratio in all patients without HCC was <1.50. When the cut-off was fixed at 1.50, sensitivity and specificity for HCC diagnosis were 60.0% and 100.0%, respectively, which are comparable to those of conventional DCP measurements in patients not taking warfarin. The novel NX-DCP ratio identifies patients on warfarin with elevated DCP due to HCC and is useful as a tumor marker for HCC in this patient subpopulation.
Department of Gastroenterology, Ogaki Municipal Hospital, Ogaki, Japan. tkumada@he.mirai.ne.jp
Hidenori
H
Toyoda
Takashi
T
Kumada
Yukio
Y
Osaki
Toshifumi
T
Tada
Yuji
Y
Kaneoka
Atsuyuki
A
Maeda
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis* / Q000097:blood*; D014408:Biomarkers, Tumor / Q000097:blood; D001774:Blood Chemical Analysis / Q000379:methods*; D006528:Carcinoma, Hepatocellular / Q000097:blood*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood*; D008297:Male; D008875:Middle Aged; D011498:Protein Precursors / Q000032:analysis* / Q000097:blood*; D011516:Prothrombin / Q000032:analysis*; D012680:Sensitivity and Specificity; D014859:Warfarin / Q000627:therapeutic use*
D015415:Biomarkers; D014408:Biomarkers, Tumor; D011498:Protein Precursors; C008208:acarboxyprothrombin; D014859:Warfarin; D011516:Prothrombin