Alpha-1-acid glycoprotein as potential biomarker for alpha-fetoprotein-low hepatocellular carcinoma

被引:18
作者
Bachtiar I. [1 ]
Kheng V. [1 ]
Wibowo G.A. [1 ]
Gani R.A. [2 ]
Hasan I. [2 ]
Sanityoso A. [2 ]
Budhihusodo U. [2 ]
Lelosutan S.A.R. [3 ]
Martamala R. [3 ]
Achwan W.A. [4 ]
Soemoharjo S. [4 ]
Sulaiman A. [5 ]
Lesmana L.A. [2 ]
Tai S. [1 ]
机构
[1] Proteomic Division, Mochtar Riady Institute for Nanotechnology, Lippo Karawaci, Tangerang
[2] Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta
[3] Gastroentero-Hepatology Division, Department of Internal Medicine, Gatot Soebroto Hospital, Jakarta
[4] Department of Internal Medicine, Mataram General Hospital, Mataram
[5] Department of Hepatology, Klinik Hati Prof. Ali Sulaiman, Jakarta
关键词
High Performance Liquid Chromatography; Positive Predictive Value; Negative Predictive Value; Multiple Affinity Removal Column; Fine Needle Aspiration Biopsy Procedure;
D O I
10.1186/1756-0500-3-319
中图分类号
学科分类号
摘要
Background. The outcome of patients with hepatocellular carcinoma (HCC) remains poor because of late diagnosis. We determined the performances of α-1-acid glycoprotein (AAG) and des-γ-carboxy prothrombin (DCP) for the diagnosis of HCC, especially for α-fetoprotein (AFP)-low HCC. Methods. Of the 220 patients included in this retrospective study, 124 had HCC, and 61 (49%) of these were AFP-low HCC (AFP ≤ 20 ng/mL). The remaining 96 patients, including 49 with chronic hepatitis B or C and 47 with cirrhosis, were considered as control. Plasma AAG was analyzed using high performance liquid chromatography (HPLC) and confirmed using Western blot technique. Results. When all patients with HCC were evaluated, the area under receiver operating characteristic (ROC) curves for AAG (0.94, 95% CI: 0.91-0.97) and DCP (0.92, 95% CI: 0.88-0.95) were similar (P = 0.40). AAG had better area under ROC curve (0.96, 95% CI: 0.94-0.99) than DCP (0.87, 95% CI: 0.81-0.93) for AFP-low HCC (P < 0.05). At the specificity 95%, the sensitivity of AAG was higher in AFP-low HCC than in AFP-high HCC (82% and 62%, respectively). In contrast, higher sensitivity was obtained from DCP in discriminating HCC patients with low AFP than that in high AFP (57% and 90%, respectively). Conclusion. Our cross-sectional study showed that AAG was better performance in diagnosing HCC patients with low AFP, while DCP did better in those with high AFP. © 2010 Bachtiar et al; licensee BioMed Central Ltd.
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共 25 条
[1]  
Bosch F.X., Ribes J., Diaz M., Cleries R., Primary liver cancer: Worldwide incidence and trends, Gastroenterology, 127, pp. 195-116, (2004)
[2]  
Taketa K., α-fetoprotein
[3]  
Revolution in hepatology, Hepatology, 12, pp. 1420-1432, (1990)
[4]  
Johnson P.J., Melia W.M., Palmer M.K., Portmann B., Williams R., Relationship between serum α-fetoprotein, cirrhosis, and survival in hepatocellular carcinoma, Br J Cancer, 44, pp. 502-505, (1981)
[5]  
Shirabe K., Takenaka K., Gion T., Shimada M., Fujiwara Y., Sugimachi K., Significance of α-fetoprotein concentrations for detection of early recurrence of hepatocellular carcinoma after hepatic resection, J Surg Oncol, 64, pp. 143-116, (1997)
[6]  
Di Bisceglie A.M., Sterling R.K., Chung R.T., Everhart J.E., Dienstag J.L., Bonkovsky H.L., Wright E.C., Everson G.T., Lindsay K.L., Lok A.S., Lee W.M., Morgan T.R., Ghany M.G., Gretch D.R., Serum α-fetoprotein levels in patients with advanced hepatitis C: Results from the HALT-C Trial, J Hepatol, 43, pp. 434-441, (2005)
[7]  
Oka H., Saito A., Ito K., Kumada T., Satomura S., Kasugai H., Osaki Y., Seki T., Kudo M., Tanaka M., Multicenter prospective analysis of newly diagnosed hepatocellular carcinoma with respect to the percentage of Lens culinaris agglutinin-reactive α-fetoprotein, J Gastroenterol Hepatol, 16, pp. 1378-1383, (2001)
[8]  
Okuda H., Obata H., Nakanishi T., Furukawa R., Hashimoto E., Production of abnormal prothrombin (des-gamma-carboxy prothrombin) by hepatocellular carcinoma: A clinical and experimental study, J Hepatol, 4, pp. 357-363, (1987)
[9]  
Li D., Mallory T., Satomura S., AFP-L3: A new generation of tumor marker for hepatocellular carcinoma, Clin Chim Acta, 313, pp. 15-19, (2001)
[10]  
Lagoa C.E., Vodovotz Y., Stolz D.B., Lhuillier F., McCloskey C., Gallo D., Yang R., Ustinova E., Fink M.P., Billiar T.R., Mars W.M., The role of hepatic type 1 plasminogen activator inhibitor (PAI-1) during murine hemorrhagic shock, Hepatology, 42, 2, pp. 390-399, (2005)