title: Diagnosis accuracy of serum glypican-3 in patients with hepatocellular carcinoma: a systematic review with meta-analysis.
abstract: OBJECTIVE
  The diagnostic value of serum GPC3 in patients with hepatocellular carcinoma (HCC) remains controversial. Thus, we performed a systematic review and meta-analysis to assess the diagnostic accuracy of serum GPC3 for HCC.
  
  
  METHODS
  A systematic search was performed for the related studies. Sensitivity, specificity and other measures regarding the accuracy of serum GPC3 and alpha-fetoprotein (AFP) in the diagnosis of HCC were pooled using random-effects models. Summary receiver operating characteristic curve (sROC) analysis was used to summarize the overall test performance.
  
  
  RESULTS
  Nineteen studies were included in this meta-analysis. Pooled sensitivity, specificity and 95% confidence interval (CI) of serum GPC3 for the diagnosis of HCC were 55.2% (52.9-57.4%) and 84.2% (82.2-86.0%), respectively. When combining GPC3 with AFP, pooled sensitivity, specificity, and 95% CI were 75.7% (71.8-79.4%) and 83.3% (79.6-86.6%), respectively. The area under sROC (AUC) and 95% CI for AFP combined with GPC3 were 0.762 (0.649-0.875). For diagnosis of early HCC, pooled sensitivity and specificity of serum GPC3 were 55.1% (47.9-66.2%) and 97.0% (95.2-98.2%), respectively. The AUC of GPC3 for early HCC was 0.793 (0.668-0.917).
  
  
  CONCLUSIONS
  This meta-analysis indicates that serum GPC3 has a comparable accuracy to AFP for the diagnosis of HCC, and there is an elevation in the sensitivity of diagnosis when GPC3 was combined with AFP. Diagnostic accuracy of serum GPC3 for early HCC is still unsatisfactory.
authors.affiliation: Third Central Clinical College of Tianjin Medical University, Tianjin, China.
authors.forename: Xiaobo
authors.initials: X
authors.lastname: Jia
authors.affiliation: Third Central Clinical College of Tianjin Medical University, Tianjin, China.
authors.forename: Jiao
authors.initials: J
authors.lastname: Liu
authors.affiliation: Key Laboratory of Artificial Cell, Institute of Hepatobiliary Disease, Tianjin Third Central Hospital Jintang Road, Hedong District, Tianjin, China.
authors.forename: Yingtang
authors.initials: Y
authors.lastname: Gao
authors.affiliation: Third Central Clinical College of Tianjin Medical University, Tianjin, China.
authors.forename: Yong
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Department of Hepatobiliary Surgery, Tianjin Third Central Hospital, Tianjin, China. Electronic address: Zhi-du@163.com.
authors.forename: Zhi
authors.initials: Z
authors.lastname: Du
mesh_terms: D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000175:diagnosis*; D005260:Female; D053673:Glypicans / Q000097:blood*; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; C105937:GPC3 protein, human; D053673:Glypicans; D000509:alpha-Fetoproteins
keywords: Diagnostic accuracy; Glypican-3; Hepatocellular carcinoma; Serum