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Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein improves diagnostic accuracy for hepatocellular carcinoma

Authors
Lee, Han AhLee, Yoo RaLee, Young-SunJung, Young KulKim, Ji HoonAn, HyungginYim, Hyung JoonJeen, Yoon TaeYeon, Jong EunByun, Kwan SooSeo, Yeon Seok
Issue Date
Jul-2021
Publisher
Baishideng Publishing Group
Keywords
Alpha-fetoprotein; Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein; Protein induced by vitamin K absence or antagonist-II; Hepatocellular carcinoma
Citation
World Journal of Gastroenterology, v.27, no.28, pp.4687 - 4696
Indexed
SCIE
SCOPUS
Journal Title
World Journal of Gastroenterology
Volume
27
Number
28
Start Page
4687
End Page
4696
URI
https://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/54242
DOI
10.3748/wjg.v27.i28.4687
ISSN
1007-9327
Abstract
BACKGROUND Diagnostic accuracy of various tumor markers and their combinations for hepatocellular carcinoma (HCC) was not fully investigated. AIM To evaluate the diagnostic accuracy of alpha-fetoprotein (AFP), the Lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), and protein induced by vitamin K absence or antagonist-II (PIVKA-II) and their combination for HCC diagnosis. METHODS Patients with newly detected liver mass or elevated serum AFP levels were considered eligible. Serum AFP level, AFP-L3 fraction, and PIVKA-II level were measured at the first visit. RESULTS In total, 622 patients were included; 355 patients (57.1%) had chronic liver disease, and 208 (33.4%) had liver cirrhosis. HCC was diagnosed in 160 patients (25.7%). The area under the receiver operating characteristics curves (AUROCs) of the serum AFP, AFP-L3 fraction, AFP-L3, and PIVKA-II levels for the diagnosis of HCC were 0.775, 0.792, 0.814, and 0.834, respectively. A novel diagnostic model was developed by classifying patients in a 1:1 ratio into training and validation sets. Using the binary regression analysis of the training cohort, the AFP, AFP-L3 fraction, and PIVKA-II (ALPs) score was calculated as follows: ALPs score = 3.8 × [serum AFP level (ng/mL) × AFP-L3 fraction (%) × 0.01] + 0.2 × PIVKA-II level (mAU/mL). The AUROC of the ALPs score for diagnosis of HCC was 0.878, significantly higher than that of serum AFP level (P < 0.001), AFP-L3 fraction (P < 0.001), PIVKA-II level (P = 0.036), and AFP-L3 level (P = 0.006). The optimal ALPs score cut-off was 5.3 (sensitivity, 85.0%, specificity 80.1%). The validation cohort showed similar results. CONCLUSION The ALPs score calculated using serum AFP level, AFP-L3 fraction, and PIVKA-II level showed improved accuracy in HCC diagnosis.
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1. Basic Science > Department of Biostatistics > 1. Journal Articles
2. Clinical Science > Department of Gastroenterology and Hepatology > 1. Journal Articles

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Yeon, Jong Eun
Guro Hospital (Department of Gastroenterology and Hepatology, Guro Hospital)
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