• Alpha-fetoprotein
• DEN-induced model
• bioavailability
• hepatocellular carcinoma
• hepatoprotective effects
• quercetin.
• silymarin

• Animals
• Quercetin/pharmacology
• Quercetin/therapeutic use
• Quercetin/administration & dosage
• Silymarin/pharmacology
• Silymarin/administration & dosage
• Silymarin/therapeutic use
• Male
• Phenobarbital/administration & dosage
• Carcinoma, Hepatocellular/drug therapy
• Carcinoma, Hepatocellular/pathology
• Rats
• Liposomes
• Dimethylnitrosamine/toxicity
• Liver Neoplasms, Experimental/drug therapy
• Liver Neoplasms, Experimental/pathology
• Liver Neoplasms, Experimental/chemically induced
• Antioxidants/pharmacology
• Antioxidants/administration & dosage
• Antioxidants/therapeutic use
• Rats, Wistar
• Liver Neoplasms/drug therapy
• Liver Neoplasms/pathology

• alpha-fetoprotein (AFP)
• alpha-fetoprotein-L3% (AFP-L3%)
• des-gamma-carboxyprothrombin (DCP)
• gender-age-AFP-L3%-AFP-DCP (GALAD) model
• hepatocellular carcinoma (HCC)

• Humans
• Carcinoma, Hepatocellular/diagnosis
• Carcinoma, Hepatocellular/therapy
• Carcinoma, Hepatocellular/pathology
• Liver Neoplasms/diagnosis
• Liver Neoplasms/therapy
• Liver Neoplasms/pathology
• Biomarkers, Tumor
• alpha-Fetoproteins
• Sensitivity and Specificity
• Protein Precursors
• Prothrombin
• Biomarkers
• Algorithms

• 2019CXJQ03 Innovation Group Project of Shanghai Municipal Health Commission
• 2018ZX10302205-003 China National Key Projects for Infectious Disease

• Carcinoma, hepatocellular
• Hepatectomy
• Liver transplantation
• Prognosis
• Radiofrequency ablation

• diagnostic biomarker
• hepatocellular carcinoma
• novel biomarker
• predictive biomarker
• prognostic biomarker

• Protein induced by vitamin K absence or antagonist-II
• chronic liver diseases
• diagnostic evaluation
• hepatocellular carcinoma
• multi-center study

• Vitamin K
• antitumor effect
• chemotherapy
• naphthoquinones
• pleotropic effect.
• safety
• synergism
• systematic review

Primary liver cancer is an aggressive, lethal malignancy that ranks as the fourth leading cause of cancer-related death worldwide. Its 5-year mortality rate is estimated to be more than 95%. This significant low survival rate is due to poor diagnosis, which can be referred to as the lack of sufficient and early-stage detection methods. Many liver cancer-associated non-coding RNAs (ncRNAs) have been extensively examined to serve as promising biomarkers for precise diagnostics, prognostics, and the evaluation of the therapeutic progress. For the simple, rapid, and selective ncRNA detection, various nanomaterial-enhanced biosensors have been developed based on electrochemical, optical, and electromechanical detection methods. This review presents ncRNAs as the potential biomarkers for the early-stage diagnosis of liver cancer. Moreover, a comprehensive overview of recent developments in nanobiosensors for liver cancer-related ncRNA detection is provided.

• biosensors
• electrochemical
• electromechanical
• liver cancer
• nanomaterials
• non-coding RNAs (ncRNAs)
• optical

The 8^th edition of the American Joint Committee on Cancer tumor-node-metastasis staging system (AJCC 8^th) has been launched with modifications in T staging. The University of Hong Kong liver cancer staging system (HKUSS) has been proven to better categorize hepatocellular carcinoma (HCC) into different T stages. This study aimed to compare the two systems’ predictive ability for HCC recurrence after primary surgical resection.

Patients who had primary, curative resection for HCC between 1989 and 2017 were reviewed. The Kaplan-Meier plot was used to estimate disease-free survival (DFS), and the log-rank test was used for survival comparison between subgroups. The two systems’ prediction of recurrence was evaluated by the Cox regression model.

Totally 1,815 patients were included. With AJCC 8^th, the 5-year DFS was 58.9% for T1a, 52.3% for T1b, 30% for T2, 16.9% for T3, and 14.4% for T4. No survival difference was demonstrated between T1a and T1b (P=0.668) or between T3 and T4 (P=0.562). With HKUSS, the 5-year DFS was 57.7% for T1, 43.4% for T2, 28.9% for T3, and 15.7% for T4. The T staging in HKUSS showed significant survival differences (T1 vs. T2, T2 vs. T3, and T3 vs. T4; P<0.001). Using receiver operating characteristic curves to show the recurrence status in the two systems, HKUSS had the largest area under curve (AUC) (HKUSS: AUC =0.655, SE 0.014, P<0.001, 95% CI, 0.628–0.681; AJCC 8^th: AUC =0.652, SE 0.013, P<0.001, 95% CI, 0.625–0.677).

HKUSS showed better categorization of HCC. In the context of primary surgical resection, HKUSS may be more appropriate for stratification of patients with HCC with various T stages, and thus the choice of staging system when primary surgical resection is considered for patients of HCC.

• 8th AJCC TNM staging
• HKU staging system
• Hepatocellular carcinoma (HCC)
• Liver Cancer Study Group of Japan
• disease-free survival (DFS)

Simple hepatic cysts are relatively common in adults, and mostly appear as asymptomatic incidental radiologic findings. Occasionally, a large cyst will cause symptoms. Elevations in the serum biomarkers protein induced by vitamin K absence (PIVKA)-II, cancer antigen (CA) 12-5, and CA19-9 are often associated with malignant tumors in the liver or bile ducts. This is the first report to describe a case of hepatic cyst with elevated levels of PIVKA-II and CA12-5. 

An 84-year-old Chinese woman was admitted with gradual abdominal distension. Her symptoms started 1 year ago, and she had poor appetite and a weight loss of 5 kg within the past 2 wk. She denied any symptoms associated with abdominal pain, fever and chills, nausea and vomiting, etc. The abdomen was enlarged, more in the right upper quadrant, without tenderness. Laboratory examination showed significantly increased serum levels of PIVKA-II, CA12-5, and CA19-9. A computed tomography scan revealed multiple round cysts in the liver with clear boundaries. The largest cyst was 20.1 cm × 12.2 cm × 19.6 cm in size, located in the right lobe of the liver with mild dilatation of the intrahepatic bile duct, but there was no contrast enhancement. Percutaneous drainage on the largest hepatic cyst and polycinnamol sclerosing agent injection into the cyst cavity were performed. After treatment, the patient’s symptoms relieved and the elevated serum tumor makers reduced to the normal levels dramatically. 

The present report identifies an unusual case of a giant hepatic cyst with marked elevation of serum tumor marker levels of PIVKA-II, CA12-5, and CA19-9. After treatment, these three serum markers dramatically decreased to normal levels. The mechanisms for the elevation of these tumor markers may be as follows: (1) A giant hepatic cyst compresses the liver, causing injury to the hepatocytes, which may lead to secretion of a large amount of PIVKA-II; and (2) Some tumor-associated antigens, such as carcinoembryonic antigen, CA19-9, CA12-5, and CA15-3, are expressed on inflammatory cells.

• Hepatic cyst
• Tumor markers
• Protein induced by vitamin K absence-II
• Cancer antigen 12-5
• Cancer antigen 19-9
• Case report

• Biomarkers
• Extended criteria
• Hepatocellular carcinoma
• Milan criteria

• Biomarkers, Tumor/blood
• Carcinoma, Hepatocellular/diagnosis
• Carcinoma, Hepatocellular/mortality
• Carcinoma, Hepatocellular/pathology
• Carcinoma, Hepatocellular/surgery
• Disease-Free Survival
• Humans
• Liver/pathology
• Liver Cirrhosis/mortality
• Liver Cirrhosis/pathology
• Liver Cirrhosis/surgery
• Liver Neoplasms/diagnosis
• Liver Neoplasms/mortality
• Liver Neoplasms/pathology
• Liver Neoplasms/surgery
• Liver Transplantation/standards
• Neoplasm Recurrence, Local/epidemiology
• Neoplasm Recurrence, Local/pathology
• Neoplasm Staging/methods
• Patient Selection
• Prognosis
• Risk Assessment/methods
• Risk Factors

Combined hepatocellular-cholangiocarcinoma (cHCC-ICC) is an uncommon and aggressive form of primary liver cancer. Currently, there are no international guidelines for optimal management. For localized tumors, radical resection represents the preferred treatment option, whereas for advanced tumors, systemic therapies recommended for intrahepatic cholangiocarcinoma (ICC) and hepatocellular carcinoma (HCC) are often selected. Emerging information from comparative cohort studies, genomic and transcriptomic data sets are starting to build a case for rationalized approaches to systemic treatment in the advanced setting specific to cHCC-ICC.

• Combined hepatocellular-cholangiocarcinoma
• biphenotypic
• cHCC-CCA
• cHCC-ICC
• genomics
• primary liver cancer
• systemic therapy

• Biomarker
• Diagnosis
• Hepatocellular carcinoma
• Proteomics
• Urine

• Alpha-fetoprotein
• Hepatitis B core-related antigen
• Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein
• Mac 2-binding protein glycan isomer
• Protein induced by vitamin K absence or antagonist-II

• biological
• liver cancer
• markers

• Animals
• Biomarkers, Tumor/metabolism
• Carcinoma, Hepatocellular/diagnosis
• Carcinoma, Hepatocellular/metabolism
• Carcinoma, Hepatocellular/pathology
• Carcinoma, Hepatocellular/therapy
• Genomics
• Humans
• Liver Neoplasms/diagnosis
• Liver Neoplasms/metabolism
• Liver Neoplasms/pathology
• Liver Neoplasms/therapy
• Neoplasm Staging
• Prognosis
• Treatment Outcome

Predicting the risk of hepatocellular carcinoma (HCC) recurrence before treatment is necessary for developing subsequent treatment policies. Several tumor markers found in blood, such as alpha-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II), are presently used to determine the occurrence and recurrence of HCC and to predict patient prognosis. However, these markers are insufficient for these purposes as certain patients have HCC recurrence despite exhibiting negative AFP and PIVKA-II. The present study identified glypican-3 (GPC3), an embryonal carcinoma antigen that is expressed specifically in HCC and is secreted into blood. Although the N-terminal domain of GPC3 in sera may be a potential prognostic factor for HCC, its biological role remains unclear. By contrast, full-length GPC3 (FL-GPC3) is reported to serve important roles in cell differentiation, proliferation and signaling events that cause HCC. Given the biological roles of FL-GPC3 in HCC progression, the present study evaluated its potential as a predictive marker of HCC recurrence. In the present study, a novel measurement system was constructed to specifically measure plasma FL-GPC3. Subsequently, its ability to predict recurrence after radical surgery in 39 HCC patients was evaluated. The results revealed that preoperative FL-GPC3 levels in patients with recurrence were significantly higher than those in patients without recurrence, suggesting that FL-GPC3 could be a better predictive maker of risk of recurrence than AFP or PIVKA-II. Furthermore, it was determined that the combination of FL-GPC3, AFP and PIVKA-II could predict recurrence within one year of radical surgery with high sensitivity and specificity. Based on these results, the validation of FL-GPC3 as a predictive marker of HCC recurrence in a larger population is warranted.

• alpha-fetoprotein
• glypican-3
• hepatocellular carcinoma
• protein induced by vitamin K absence or antagonist-II
• tumor marker

• Direct antiviral agents
• HCC pattern
• Hepatitis C virus
• Hepatocellular carcinoma

Hepatocellular carcinoma (HCC) remains a major cause of cancer-related mortality worldwide. Delayed diagnosis is a major factor responsible for the poor prognosis of HCC. Several advances have been made in the field of liver imaging with the use of novel imaging contrasts, improving current imaging techniques with contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI), introduction of new technologies such as contrast liver ultrasound, and development of novel biomarkers with the goal of early detection of HCC and improving outcomes of patients with HCC. This review focuses on current surveillance strategies and development of biomarkers with the goal of early detection of HCC.

• CT
• HCC
• MRI
• biomarkers
• liquid biopsy
• surveillance
• ultrasound

We report a rare case of marked elevation of α-fetoprotein in the absence of hepatocellular carcinoma caused by a relapse of hepatitis C virus (HCV) infection. A 58-year-old man underwent liver transplantation to treat hepatocellular carcinoma caused by HCV-related liver cirrhosis. The HCV was of genotype 2a, and the ribonucleic acid titer was >8.0 log IU/mL. Direct-acting antiviral drugs were prescribed for 12 weeks; however, the HCV infection relapsed after treatment had ended, and α-fetoprotein levels increased to 8,981 ng/mL. Imaging did not reveal any malignancies. The patient initiated interferon therapy, at which time AFP levels decreased, and the HCV was successfully cleared.

Liver transplantation (LT) is the optimal therapeutic option for patients with liver cirrhosis and hepatocellular carcinoma (HCC). Due to universal donor shortage, only the patients with limited tumor burden (under the so-called Milan criteria) are considered as potential candidates for LT in most institutions. It is expected that in the near future, more liver grafts will be available for patients with HCC due to the implementation of new direct antivirals against hepatitis C, leaving a prone scenario to consider expanding Milan criteria. A moderate expansion of Milan criteria could be implemented without increasing the risk of tumor recurrence if patients with favorable biological behavior are carefully selected. Incorporating information regarding tumor biology in the decision-making algorithm would result in a more rational use of LT in patients with HCC. In the present review, surrogate markers of tumor biology are critically evaluated as potential tools to be combined with existing radiological criteria. In addition, the current state of liquid biopsy is discussed, as this cutting-edge technology may reshape the management of HCC in the upcoming years.

• alpha-fetoprotein
• biomarkers
• cell-free DNA
• circulating tumor cells
• liquid biopsy
• locoregional ablation

Glypican-3 (GPC3) is a glycosylphosphatidylinositol-anchored cell surface protein overexpressed in hepatocellular carcinoma(HCC), and its overexpression is associated with poor prognosis. The diagnostic potential of GPC3 as a serum marker has been reported. In the present study, we evaluated the usefulness of plasma GPC3 as a predictor for recurrence after surgical resection in stage I HCC patients by newly developed an enzyme-linked immunosorbent assay (ELISA) system. Current study demonstrated that high levels of preoperative plasma GPC3 patients tended to experience postoperative recurrence. On the other hand, pre- and postoperative plasma GPC3 positivity of non-recurrence patients was very low. Moreover, even after surgery, approximately half of patients who experienced recurrence were positive for plasma GPC3. Postoperative plasma GPC3 positivity was significantly correlated with worse recurrence-free survival. Immuohistochemical analysis also showed positive rate of GPC3-expression in HCC was higher in recurrence patients than in non-recurrence patients. These results suggested that both pre- and postoperative plasma GPC3 levels may be accurate predictors for recurrence after curative resection of early-stage HCC. It should be noted that the current study only examined a small number of cases; thus, a larger sample size is necessary to validate GPC3 as a predictor for HCC recurrence.

• enzyme-linked immunosorbent assay
• glypican-3
• hepatocellular carcinoma
• recurrence
• tumor marker

• MT1M
• hepatocellular carcinoma
• metallothionein 1M
• tumor marker

• Chronic hepatitis C
• Direct-acting antiviral treatment
• Hepatocellular carcinoma
• Rapidly growing
• Sustained virological response

• Antineoplastic Agents/administration & dosage
• Antiviral Agents/therapeutic use
• Carcinoma, Hepatocellular/complications
• Carcinoma, Hepatocellular/diagnostic imaging
• Carcinoma, Hepatocellular/pathology
• Carcinoma, Hepatocellular/therapy
• Fatal Outcome
• Hepatitis C, Chronic/complications
• Hepatitis C, Chronic/drug therapy
• Humans
• Infusions, Intra-Arterial
• Liver Neoplasms/complications
• Liver Neoplasms/diagnostic imaging
• Liver Neoplasms/pathology
• Liver Neoplasms/therapy
• Male
• Middle Aged
• Radiotherapy, Adjuvant

More than 70% of hepatocellular carcinoma (HCC) cases develop as a consequence of liver cirrhosis (LC). Here we have evaluated the diagnostic potential of four serum biomarkers, and developed models for HCC diagnosis and differentiation from LC patients. Serum levels of α-fetoprotein (AFP), AFP-L3, des-γ-carboxy prothrombin (DCP), and Golgi protein 73 (GP73) were analyzed in 114 advanced HCC patients, 81 early stage HCC patients, and 152 LC patients. Multilayer perceptron (MLP) and radial basis function (RBF) neural networks were used to construct the diagnostic models. Using all stages, HCC diagnostic models had a higher sensitivity (>70%) than the individual serum biomarkers, whereas only early stage HCC diagnostic models had a higher specificity (>80%). The early stage HCC diagnostic models could not be used as HCC screening tools due to their low sensitivity (about 40%). These results suggest that a combination of the two models might be used as a screening tool to distinguish early stage HCC patients from LC patients, thus improving prevention and treatment of HCC.

• artificial neural network
• hepatocellular carcinoma
• serum tumor biomarker

• biomarker
• cirrhosis
• fibrosis
• hepatocellular carcinoma
• soluble Axl

• Asia
• Biomarkers, Tumor/blood
• Carcinoma, Hepatocellular/diagnosis
• Carcinoma, Hepatocellular/pathology
• Chronic Disease
• Early Diagnosis
• Europe
• Female
• Fibrosis
• Gene Expression Regulation, Neoplastic
• Humans
• Liver/pathology
• Liver Cirrhosis/diagnosis
• Liver Cirrhosis/pathology
• Liver Neoplasms/pathology
• Male
• Middle Aged
• Myofibroblasts/metabolism
• Myofibroblasts/pathology
• Proto-Oncogene Proteins/blood
• Receptor Protein-Tyrosine Kinases/blood
• Risk
• Sensitivity and Specificity
• Up-Regulation
• Axl Receptor Tyrosine Kinase

• Hepatocellular carcinoma
• biomarker
• circulating-tumor DNA
• hepatitis B virus
• liver cancer
• recurrence
• urine tumor marker

• Hepatocellular carcinoma
• hepatitis B virus
• serum biomarker
• the area under receiver operating characteristic

• blood markers
• diagnosis
• liver cancer

• Biomarker
• Diagnosis
• Hepatocellular carcinoma
• Protein induced by vitamin K antagonist-II
• Treatment outcome

Prognosis of hepatocellular carcinoma (HCC) remains unsatisfying due to a lack of early detecting methods. Protein Induced by Vitamin K Absence or Antagonist-II (PIVKA-II) has been proved to be an efficient biomarker for HCC. However, the predicting efficacy of PIVKA-II has barely been reported. In the Hepatitis Biobank of Southwest Hospital (HBS) cohort at Southwest Hospital, we did a two-stage nested case-control study. Totally, 45 HCC cases versus 138 matched controls were enrolled to compare levels of α-fetoprotein (AFP) and PIVKA-II in sequential sera at −12, −9, −6, −3 and 0 months before imaging diagnosis. Levels of both PIVKA-II and AFP in HCC cases elevated significantly at all time points compared with controls. In validation stage, the sensitivity and specificity of PIVKA-II at baseline were 58.3% and 92.6%, and AFP were 75.0% and 91.7%. AFP-/PIVKA-II+ patients covered 27.4%, 29.4% and 19.6% at M-12, M-6 and M-0, respectively, while AFP+/PIVKA-II- patients covered 25.5%, 19.6% and 17.7%, respectively. Both PIVKA-II and AFP have the potential for HCC prediction, while PIVKA-II has a better positive rate than AFP before diagnosis.

• Biomarkers/blood
• Biomarkers, Tumor/blood
• Carcinoma, Hepatocellular/blood
• Carcinoma, Hepatocellular/diagnosis
• Humans
• Liver Neoplasms/blood
• Liver Neoplasms/diagnosis
• Predictive Value of Tests
• Protein Precursors/blood
• Prothrombin
• Reference Values

• Adjuvant treatment
• Biological marker
• Downstaging therapy
• Hepatocellular carcinoma
• Liver transplantation
• Milan criteria

• Biomarkers, Tumor/blood
• Carcinoma, Hepatocellular/blood
• Carcinoma, Hepatocellular/diagnosis
• Carcinoma, Hepatocellular/pathology
• Carcinoma, Hepatocellular/surgery
• Decision Support Techniques
• Humans
• Liver Neoplasms/blood
• Liver Neoplasms/diagnosis
• Liver Neoplasms/pathology
• Liver Neoplasms/surgery
• Liver Transplantation/adverse effects
• Neoadjuvant Therapy
• Neoplasm Staging
• Patient Selection
• Predictive Value of Tests
• Risk Factors
• Treatment Outcome
• Tumor Burden

• AFP
• DCP
• Portal vein thrombosis
• Survival

• AFP
• AFP-L3
• PIVKA-II
• biomarker
• hepatocellular carcinoma

• biomarkers
• cirrhosis
• hepatocellular carcinoma
• infection
• liver
• surveillance

Hepatocellular carcinoma (HCC) is the fifth most common cancer and the second leading cause of cancer-related deaths worldwide. Although the prognosis of patients with HCC is generally poor, the 5-year survival rate is > 70% if patients are diagnosed at an early stage. However, early diagnosis of HCC is complicated by the coexistence of inflammation and cirrhosis. Thus, novel biomarkers for the early diagnosis of HCC are required. Currently, the diagnosis of HCC without pathological correlation is achieved by analyzing serum α-fetoprotein levels combined with imaging techniques. Advances in genomics and proteomics platforms and biomarker assay techniques over the last decade have resulted in the identification of numerous novel biomarkers and have improved the diagnosis of HCC. The most promising biomarkers, such as glypican-3, osteopontin, Golgi protein-73 and nucleic acids including microRNAs, are most likely to become clinically validated in the near future. These biomarkers are not only useful for early diagnosis of HCC, but also provide insight into the mechanisms driving oncogenesis. In addition, such molecular insight creates the basis for the development of potentially more effective treatment strategies. In this article, we provide an overview of the biomarkers that are currently used for the early diagnosis of HCC.

• α-fetoprotein
• α-fetoprotein-L3
• Biomarker
• Des-γ-carboxyprothrombin
• Glypican-3
• Golgi protein-73
• Hepatocellular carcinoma
• MicroRNAs
• Osteopontin
• Squamous cell carcinoma antigen

• Annexin A2/metabolism
• Antigens, Neoplasm/metabolism
• Biomarkers/metabolism
• Biomarkers, Tumor/metabolism
• Carcinoma, Hepatocellular/diagnosis
• Carcinoma, Hepatocellular/metabolism
• Early Detection of Cancer
• Fibrosis/complications
• Glypicans/metabolism
• Humans
• Inflammation/complications
• Liver Neoplasms/diagnosis
• Liver Neoplasms/metabolism
• Membrane Proteins/metabolism
• MicroRNAs/metabolism
• Midkine
• Nerve Growth Factors/metabolism
• Osteopontin/metabolism
• Protein Precursors/metabolism
• Prothrombin/metabolism
• Receptors, Urokinase Plasminogen Activator/metabolism
• Serpins/metabolism
• Thioredoxins/metabolism
• alpha-Fetoproteins/metabolism

• biomarker
• hepatocellular carcinoma
• soluble Axl
• α-fetoprotein

• Aged
• Biomarkers/metabolism
• Carcinoma, Hepatocellular/diagnosis
• Carcinoma, Hepatocellular/pathology
• Carcinoma, Hepatocellular/surgery
• Cohort Studies
• Female
• Humans
• Liver Neoplasms/diagnosis
• Liver Neoplasms/pathology
• Liver Neoplasms/surgery
• Liver Transplantation/methods
• Male
• Middle Aged
• Neoplasm Recurrence, Local/diagnosis
• Neoplasm Recurrence, Local/pathology
• Plant Lectins/chemistry
• Proportional Hazards Models
• Protein Precursors/metabolism
• Prothrombin/metabolism
• Retrospective Studies
• Severity of Illness Index
• Signal Transduction
• Tomography, X-Ray Computed/methods
• alpha-Fetoproteins/metabolism

• R01 CA100882 NCI NIH HHS
• UL1 TR000135 NCATS NIH HHS
• P30 DK084567 NIDDK NIH HHS
• CA128633 NCI NIH HHS
• R21 CA128633 NCI NIH HHS
• CA100882 NCI NIH HHS
• P30DK084567 NIDDK NIH HHS
• P30 CA015083 NCI NIH HHS
• R56 CA100882 NCI NIH HHS
• N01 CA015083 NCI NIH HHS

• Alpha fetoprotein
• Cancer screening
• Desgamma carboxy prothrombin
• Hepatocellular carcinoma
• Ultrasonography

Background. There have been many reports on des-γ-carboxy prothrombin (DCP) as a promising serum marker in the diagnosis of hepatocellular carcinoma (HCC); however, the results are inconsistent and even conflicting. Methods. This meta-analysis was performed to investigate the performance of DCP in the diagnosis of HCC. Following a systematic review of relevant studies, Meta-DiSc 1.4 software was used to extract data and to calculate the overall sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). Data are presented as forest plots and summary receiver operating characteristic curve (SROC) analysis was used to summarize the overall test performance. Results. Twelve studies were included in our meta-analysis. The overall sensitivity, specificity, PLR, and NLR of DCP for the detection of HCC in the studies included were 71% (95%CI: 68%–73%), 84% (95%CI: 83%–86%), 6.48 (95%CI: 4.22–9.93), and 0.33 (95%CI: 0.25–0.43), respectively. The area under the SROC curve was 0.8930 and the Q index was 0.8238. Significant heterogeneity was found. Conclusion. This meta-analysis indicated that DCP had moderate diagnostic accuracy in HCC. Further studies with rigorous design, large sample size, and mmultiregional cooperation are needed in the future.