title: Significance of combined tests of serum golgi glycoprotein 73 and other biomarkers in diagnosis of small primary hepatocellular carcinoma.
abstract: BACKGROUND
  The most practical serum biomarker AFP is negative in 80% patients with small tumor in the early stage of primary hepatocellular carcinoma (PHC).
  
  
  OBJECTIVE
  To investigate significance of combined tests of serum golgi glycoprotein 73 (GP73), lens culinaris agglutinin-reactive alpha-fetoprotein (AFP-L3), glypican 3 (GPC3), des-gamma-carboxy prothrombin (DCP), CA199, ferritin (FER) and carcinoembryonic antigen (CEA) in diagnosis of small PHC with negative AFP.
  
  
  METHODS
  A total of 50 cases of small PHC, 60 cases of non-PHC digestive system disorders and 40 cases of healthy controls were collected. Serum GP73, GPC3 and DCP were analyzed by enzyme-1inked immunosorbent assay. AFP-L3 was separated by microspincolumn; the levels of CA199, FER, CEA, AFP-L3 and total AFP were quantified by electrochemiluminescence immunoassays; percentage of AFP-L3 to total AFP was calculated.
  
  
  RESULTS
  Levels of those biomarkers except FER were all significantly different among three groups (P < 0.01). Positive detection rates of seven biomarkers in PHC were higher than other groups (P < 0.01). In individual detection, the highest sensitivity, accuracy rate and area under ROC curve were 72.0%, 86.7% and 0.826 by GP73 and the highest specificity was 98.0% by GPC3. In combined detection with those seven biomarkers, the sensitivity, specificity, accuracy rate and area under ROC curve were 82.0%, 95.0%, 90.1% and 0.884.
  
  
  CONCLUSIONS
  GP73 and AFP-L3 are superior biomarkers to aid the diagnosis of small PHC with negative AFP. The combined detection of biomarkers improved the diagnostic accuracy.
authors.affiliation: Department of Clinical Laboratory, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China.
authors.forename: Yunsheng
authors.initials: Y
authors.lastname: Zhao
authors.affiliation: Department of Clinical Laboratory, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China.
authors.forename: Meng
authors.initials: M
authors.lastname: Wang
authors.affiliation: Department of Clinical Laboratory, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China.
authors.forename: Chenying
authors.initials: C
authors.lastname: Cui
authors.affiliation: Department of Clinical Laboratory, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China.
authors.forename: Lina
authors.initials: L
authors.lastname: Zhang
authors.affiliation: Key Laboratory of Medical Laboratory Diagnostics of the Education Ministry, College of Laboratory Medicine, Chongqing Medical University, Chongqing, China.
authors.forename: Fei
authors.initials: F
authors.lastname: Liao
authors.affiliation: Department of Clinical Laboratory, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China.
authors.forename: Hongchen
authors.initials: H
authors.lastname: Li
authors.affiliation: Department of Clinical Laboratory, The First Hospital of Qinhuangdao, Qinhuangdao, Hebei, China.
authors.forename: Xia
authors.initials: X
authors.lastname: Wu
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015295:Antigens, Tumor-Associated, Carbohydrate / Q000097:blood; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000473:pathology; D005260:Female; D005293:Ferritins / Q000097:blood; D053673:Glypicans / Q000097:blood; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology; D008297:Male; D008565:Membrane Proteins / Q000097:blood*; D008875:Middle Aged; D037121:Plant Lectins / Q000097:blood*; D000509:alpha-Fetoproteins / Q000378:metabolism
chemical_list: D015295:Antigens, Tumor-Associated, Carbohydrate; D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen; C410824:GOLM1 protein, human; C105937:GPC3 protein, human; D053673:Glypicans; D008565:Membrane Proteins; D037121:Plant Lectins; D000509:alpha-Fetoproteins; C578959:carbohydrate antigen 199, human; C033619:lentil lectin; D005293:Ferritins
keywords: Primary hepatocellular carcinoma; biomarkers; combined detection; diagnosis