title: Combined analysis of AFP and HCCR-1 as an useful serological marker for small hepatocellular carcinoma: a prospective cohort study.
abstract: Hepatocellular carcinoma (HCC) is one of the most frequent malignant tumors in the world. The only serological marker widely used for the diagnosis of HCC is alpha-fetoprotein (AFP). Despite that AFP is widely used for the diagnosis of HCC, it has a limit as a serological marker due to its low sensitivity and specificity. The human cervical cancer proto-oncogene 1 (HCCR-1) was previously reported as a new biomarker for HCC. To further evaluate the HCCR-1 as a biomarker for HCC, we conducted the prospective cohort study. We evaluated the significance of simultaneous measurement of 2 tumor markers in the diagnosis of HCC in China, Japan and Korea. Two markers for HCC, AFP and HCCR-1, were measured in the sera obtained from 1,338 patients at the time of initial diagnosis of HCC. Of the 1338 HCC patients, 616 (46%) and 686 (51.3%) were sero-positive for AFP and HCCR-1, respectively. The positive rate for HCC was increased up to 74.1% in combined use of AFP and HCCR-1. Many cases (54%) for AFP-negative HCC were positive for HCCR-1 and vice versa. More importantly, the diagnostic rate for small HCC (< 2 cm) was significantly improved in the combined analysis of AFP and HCCR-1 to 56.9% although it was only 40.1% and 23.4% in the single analysis of HCCR-1 and AFP, respectively. Our result suggests that the HCCR-1 could be an useful biomarker for HCC while the diagnostic rate could be significantly improved in the combined use of HCCR-1 and AFP.
authors.affiliation: Department of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China.
authors.forename: Guoxin
authors.initials: G
authors.lastname: Zhang
authors.forename: Seon-Ah
authors.initials: SA
authors.lastname: Ha
authors.forename: Hyun K
authors.initials: HK
authors.lastname: Kim
authors.forename: Jinah
authors.initials: J
authors.lastname: Yoo
authors.forename: Sanghee
authors.initials: S
authors.lastname: Kim
authors.forename: Youn S
authors.initials: YS
authors.lastname: Lee
authors.forename: Soo Y
authors.initials: SY
authors.lastname: Hur
authors.forename: Yong W
authors.initials: YW
authors.lastname: Kim
authors.forename: Tae E
authors.initials: TE
authors.lastname: Kim
authors.forename: Yong G
authors.initials: YG
authors.lastname: Park
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Yang
authors.initials: Y
authors.lastname: Yang
authors.forename: Zekuan
authors.initials: Z
authors.lastname: Xu
authors.forename: Eun Y
authors.initials: EY
authors.lastname: Song
authors.forename: Zuhu
authors.initials: Z
authors.lastname: Huang
authors.forename: Peng
authors.initials: P
authors.lastname: Jirun
authors.forename: Jin
authors.initials: J
authors.lastname: Zhongtian
authors.forename: Qiao
authors.initials: Q
authors.lastname: Shishi
authors.forename: Cui
authors.initials: C
authors.lastname: Zhuqingqing
authors.forename: Gong
authors.initials: G
authors.lastname: Lei
authors.forename: Jin W
authors.initials: JW
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D055088:Early Detection of Cancer / Q000379:methods; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000175:diagnosis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D000090063:Proto-Oncogene Mas; D011518:Proto-Oncogene Proteins / Q000097:blood*; D012372:ROC Curve; D047368:Tumor Burden; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; C476732:LETMD1 protein, human; C000715470:MAS1 protein, human; D000090063:Proto-Oncogene Mas; D011518:Proto-Oncogene Proteins; D000509:alpha-Fetoproteins