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

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dc.contributor.authorLee, Han Ah-
dc.contributor.authorLee, Yoo Ra-
dc.contributor.authorLee, Young-Sun-
dc.contributor.authorJung, Young Kul-
dc.contributor.authorKim, Ji Hoon-
dc.contributor.authorAn, Hyunggin-
dc.contributor.authorYim, Hyung Joon-
dc.contributor.authorJeen, Yoon Tae-
dc.contributor.authorYeon, Jong Eun-
dc.contributor.authorByun, Kwan Soo-
dc.contributor.authorSeo, Yeon Seok-
dc.date.accessioned2021-09-17T02:40:18Z-
dc.date.available2021-09-17T02:40:18Z-
dc.date.issued2021-07-
dc.identifier.issn1007-9327-
dc.identifier.issn2219-2840-
dc.identifier.urihttps://scholarworks.korea.ac.kr/kumedicine/handle/2020.sw.kumedicine/54242-
dc.description.abstractBACKGROUND 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.-
dc.format.extent10-
dc.language영어-
dc.language.isoENG-
dc.publisherBaishideng Publishing Group-
dc.titleLens culinaris agglutinin-reactive fraction of alpha-fetoprotein improves diagnostic accuracy for hepatocellular carcinoma-
dc.typeArticle-
dc.publisher.location미국-
dc.identifier.doi10.3748/wjg.v27.i28.4687-
dc.identifier.scopusid2-s2.0-85111187045-
dc.identifier.wosid000683005300011-
dc.identifier.bibliographicCitationWorld Journal of Gastroenterology, v.27, no.28, pp 4687 - 4696-
dc.citation.titleWorld Journal of Gastroenterology-
dc.citation.volume27-
dc.citation.number28-
dc.citation.startPage4687-
dc.citation.endPage4696-
dc.type.docTypeArticle-
dc.description.isOpenAccessN-
dc.description.journalRegisteredClassscie-
dc.description.journalRegisteredClassscopus-
dc.relation.journalResearchAreaGastroenterology & Hepatology-
dc.relation.journalWebOfScienceCategoryGastroenterology & Hepatology-
dc.subject.keywordPlusGAMMA-CARBOXY PROTHROMBIN-
dc.subject.keywordPlusPIVKA-II-
dc.subject.keywordPlusBIOMARKERS-
dc.subject.keywordPlusMARKER-
dc.subject.keywordPlusAFP-L3-
dc.subject.keywordPlusPREDICTION-
dc.subject.keywordPlusUTILITY-
dc.subject.keywordPlusSERUM-
dc.subject.keywordAuthorAlpha-fetoprotein-
dc.subject.keywordAuthorLens culinaris agglutinin-reactive fraction of alpha-fetoprotein-
dc.subject.keywordAuthorProtein induced by vitamin K absence or antagonist-II-
dc.subject.keywordAuthorHepatocellular carcinoma-
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