The assessment of new high sensitivity tumoral markers for hepatocellular carcinoma (HCC) represents a useful tool in the diagnosis of small liver tumors, still amenable by surgery. We have evaluated the efficacy of the tumoural markers proposed over the past years for the study of the HCC, such as the α1-fetoprotein (AFP) the carcinoembryonic antigen (CEA), the serum ferritin (FS), the polypeptide tissutal antigen (TPA) and, lastly, of the des-γ-carboxy prothrombin (DCP), of more recent proposal. Of the 227 patients included in the study, 111 had HCC and of these 85 were cirrhotics. The remaining 116 were considered as the control group, and they included 23 patients with liver metastases, 26 with benign hepatic masses, 20 with tumours different from the HCC and 47 cases with other liver diseases. For each single tumoural marker, the sensibility, the specificity, the positive predictive value, the negative predicting value, the diagnostic accuracy and the Younden index were assessed in the diagnosis of the HCC. The AFP and the DCP were shown to be the most effective, with sensibility, specificity and diagnostic accuracy of 54.9%, 97.4%, 76.6% and of 53.3%, 88.1% and 71.1. respectively. The same parameters evaluated for the combined use of the two markers employed together were 74.2%, 87.2% and 80.9% respectively. No other significative improvement came out from the analysis of the other markers considered. Of the 111 patients with HCC, 35 (33.3%) were positive for both AFP and DCP, 43 (41%) were positive for one of them, and 27 (25.7%) were completely negative. In the 44 patients were a liver resection or a liver transplantation was performed, the DCP was significantly correlated with the hystological presence of microvascular thrombosis, that is the major determinant in long term survival after curative procedures. The DCP is a tumoral marker of HCC almost as effective as the AFP; the combined use of AFP and DCP significantly improves the diagnostic performances in the serological diagnosis of the HCC.
|Translated title of the contribution||The des-γ-carboxy prothrombin in the diagnosis of hepatocellular carcinoma. Comparison with other tumor markers|
|Number of pages||7|
|Publication status||Published - 1994|
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