title: Alpha-fetoprotein-L3 in hepatocellular carcinoma: a meta-analysis.
abstract: OBJECTIVE
  Alpha-fetoprotein (AFP) has been widely used as a diagnostic marker. AFP is also increased in patients at high risk for hepatocellular carcinoma (HCC), ie those with chronic hepatitis. The percentage of lens culinaris agglutinin-reactive alpha-fetoprotein (AFP-L3%) has long been proposed as a marker for HCC, but has not been widely adopted due to inconsistent results reported in the literature. In this study, the performance of AFP-L3% is specifically evaluated for diagnosis of HCC.
  
  
  METHODS
  A systematic review of relevant studies, the sensitivity, specificity, and diagnostic odds ratio (DOR) for the diagnosis of HCC were pooled using random-effects models. The overall test performance was summarized using summary receiver operating characteristic (SROC) curve analysis. Potential between-study heterogeneity was explored by meta-regression model.
  
  
  RESULTS
  Twelve articles were included in this meta-analysis. The overall estimates of AFP-L3% in detecting HCC were as follows: pooled sensitivity, 0.483 (95% confidence interval (CI) 0.459-0.507); pooled specificity, 0.929 (95% CI 0.916-0.940); DOR, 12.33 (95% CI 7.82-19.44); and area under the curve (AUC), 0.7564.
  
  
  CONCLUSIONS
  AFP-L3% could be complementary to AFP as a marker for HCC.
authors: Department of Clinical Laboratory, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, PR China. Electronic address: yxy901224@163.com.
authors: Xiaoyan
authors: X
authors: Yi
authors: Shuang
authors: S
authors: Yu
authors: Yixi
authors: Y
authors: Bao
mesh_terms: D019540:Area Under Curve; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000175:diagnosis; D016206:Databases, Bibliographic; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000175:diagnosis; D016017:Odds Ratio; D037121:Plant Lectins / Q000737:chemistry; D011237:Predictive Value of Tests; D020033:Protein Isoforms / Q000097:blood; D012372:ROC Curve; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D037121:Plant Lectins; D020033:Protein Isoforms; D000509:alpha-Fetoproteins; C033619:lentil lectin
keywords: AFP-L3; Diagnosis; Hepatocellular carcinoma; Meta-analysis