The DOI matches its Crossref record; 24 of the 24 references it cites were found in a registry or an index.
α-Fetoprotein, Des-γ Carboxyprothrombin, and Lectin-Bound α-Fetoprotein in Early Hepatocellular Carcinoma
Open accessAbstract
Background and Aims Alpha-fetoprotein (AFP) is widely used as a surveillance test for Hepatocellular carcinoma (HCC) among patients with cirrhosis. Des-gamma carboxy-prothrombin (DCP) and lectin-bound AFP (AFP-L3) are potential surveillance tests for HCC. The aims of this study were to determine performance of DCP and AFP-L3 for the diagnosis of early HCC, whether they complement AFP, and what factors affect DCP, AFP-L3 or AFP levels. Methods We conducted a large phase 2 biomarker case-control study in 7 academic medical centers in the United States. Controls were patients with compensated cirrhosis and cases were patients with HCC. AFP, DCP and AFP-L3 levels were measured blinded to clinical data in a central reference laboratory. Results A total of 836 patients were enrolled, 417 (50%) were cirrhosis controls and 419 (50%) were HCC cases, of which 208 (49.6%) had early stage HCC (n=77 very early, n=131 early). AFP had the best area under the ROC curve (0.80, 95%CI: 0.77–0.84) followed by DCP (0.72, 95%CI: 0.68–0.77) and AFP-L3% (0.66, 95%CI: 0.62–0.70) for early stage HCC. The optimal AFP cutoff value was 10.9 ng/ml leading to a sensitivity of 66%. When only those with very early HCC were evaluated, the AUC for AFP was 0.78 (95%CI: 0.72–0.85) leading to a sensitivity of 65% at the same cutoff. Conclusion AFP was more sensitive than DCP and AFP-L3 for the diagnosis of early and very early stage HCC at a new cutoff of 10.9 ng/mL.
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EASL Clinical Practice Guidelines: Management of hepatocellular carcinoma
Galle, P. R., Forner, A., Llovet, J. M., Mazzaferro, V., Piscaglia, F., Raoul, J.-L., Schirmacher, P., & Vilgrain, V. (2018) · Journal of Hepatology · doi:10.1016/j.jhep.2018.03.019 · Cited by 11,406
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“…vitamin K absence/antagonist-II (PIVKA-II), a variant of prothrombin that is also specifically produced at high levels by a proportion of HCCs. [76,77] These biomarkers are currently Food and Drug Administration (FDA) approved for risk stratification but not HCC surveillance in the United States.”
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Metadata
- Authors
- Marrero, J. A., Feng, Z., Wang, Y., Nguyen, M. H., Befeler, A. S., Roberts, L. R., Reddy, K. R., Harnois, D., Llovet, J. M., Normolle, D., Dalhgren, J., Chia, D., Lok, A. S., Wagner, P. D., Srivastava, S., & Schwartz, M.
- Venue
- Gastroenterology
- Publisher
- Elsevier BV
- Published
- 2009-07
- Volume
- 137
- Issue
- 1
- Pages
- 110-118
- ISSN
- 0016-5085 (ISSN-L)
- OpenAlex
- W1995180061
- Cited by
- 745
- References
- 24
- FWCI
- 18.43
- Type
- journal article
- Language
- en
- Open access
- green
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