title: Diagnostic accuracy of serum glypican-3 for hepatocellular carcinoma: a systematic review and meta-analysis.
abstract: OBJECTIVE
  Many individual studies have evaluated the diagnostic efficiency of serum glypican-3 (GPC-3) for diagnosing hepatocellular carcinoma (HCC), but the results have been inconsistent. The aim of present study was to meta-analyze the overall diagnostic accuracy of serum GPC-3 for diagnosing HCC.
  
  
  METHODS
  English language studies which evaluated the diagnostic performance of GPC-3 and published before March 22, 2013 were retrieved. The quality of the studies was assessed by revised QUADAS tools. The performance characteristics were pooled and determined by random-effects models.
  
  
  RESULTS
  Twelve studies with a total of 898 HCC patients and 835 non-HCC patients were included. For the studies in which the majority of reference participants had HBV or HCV infections, the overall diagnostic sensitivity and specificity were 0.53 (95% CI: 0.49-0.57) and 0.77 (95% CI: 0.74-0.81), respectively. The area under summary receiver operating characteristic (sROC) curves (AUC) was 0.82. The major design deficiencies of included studies were differential verification bias, and a lack of clear exclusion and inclusion criteria.
  
  
  CONCLUSIONS
  GPC-3 has moderate diagnostic accuracy for HCC. Due to the design limitations, results in published studies should be carefully interpreted. In addition, more well-designed studies with large sample sizes should be performed to rigorously evaluate the diagnostic value of the GPC-3.
authors.affiliation: Department of Laboratory Medicine, General Hospital of Ji'nan Military Region of PLA, Ji'nan, 250031 Shandong Province, PR China.
authors.forename: Xiao-Fei
authors.initials: XF
authors.lastname: Liu
authors.affiliation: Department of Laboratory Medicine, General Hospital of Ji'nan Military Region of PLA, Ji'nan, 250031 Shandong Province, PR China.
authors.forename: Zhi-De
authors.initials: ZD
authors.lastname: Hu
authors.affiliation: Department of Ophthalmology, Chinese PLA (People's Liberation Army) General Hospital, Beijing 100853, China.
authors.forename: Xiao-Cui
authors.initials: XC
authors.lastname: Liu
authors.affiliation: Department of Laboratory Medicine, General Hospital of Ji'nan Military Region of PLA, Ji'nan, 250031 Shandong Province, PR China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Cao
authors.affiliation: Department of Laboratory Medicine, General Hospital of Ji'nan Military Region of PLA, Ji'nan, 250031 Shandong Province, PR China.
authors.forename: Chun-Mei
authors.initials: CM
authors.lastname: Ding
authors.affiliation: Department of Laboratory Medicine, General Hospital of Ji'nan Military Region of PLA, Ji'nan, 250031 Shandong Province, PR China. Electronic address: hcj6289@163.com.
authors.forename: Cheng-Jin
authors.initials: CJ
authors.lastname: Hu
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D053673:Glypicans / Q000097:blood*; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000175:diagnosis*; D008297:Male; D012680:Sensitivity and Specificity
chemical_list: C105937:GPC3 protein, human; D053673:Glypicans
keywords: Diagnostic value; Glypican-3; Hepatocellular carcinoma; Systematic review