Oncotarget

Research Papers:

Combination of dual serum fluorescence, AFP and hepatic function tests is valuable to identify HCC in AFP-elevated liver diseases

Ting Wang, Kun-He Zhang _, Piao-Ping Hu, Qin-Si Wan, Fang-Li Han, Jian-Ming Zhou, De-Qiang Huang and Nong-Hua Lv

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Oncotarget. 2017; 8:97758-97768. https://doi.org/10.18632/oncotarget.22050

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Abstract

Ting Wang1, Kun-He Zhang1, Piao-Ping Hu1, Qin-Si Wan1, Fang-Li Han1, Jian-Ming Zhou1, De-Qiang Huang1 and Nong-Hua Lv1

1Department of Gastroenterology, The First Affiliated Hospital of Nanchang University, Jiangxi Institute of Gastroenterology and Hepatology, Nanchang 330006, China

Correspondence to:

Kun-He Zhang, email: [email protected]

Keywords: hepatocellular carcinoma; AFP-elevated liver diseases; dual serum fluorescence; hepatic function tests; diagnostic model

Received: August 23, 2017     Accepted: October 03, 2017     Published: October 25, 2017

ABSTRACT

Serum alpha-fetoprotein (AFP) levels elevated in benign liver diseases (BLD) represent a challenge in hepatocellular carcinoma (HCC) diagnosis. The present study aimed to develop a simple method to identify HCC in AFP-elevated liver diseases based on combining serum fluorescence and general clinical data. Serum specimens and clinical data were collected from 201 HCC and 117 BLD (41 liver cirrhosis, 76 chronic hepatitis) patients with abnormal serum AFP levels. Dual serum fluorescence (autofluorescence and cell-free DNA-related fluorescence) intensities were sequentially measured and expressed as 6 fluorescence indicators. The diagnostic value of these fluorescence and clinical data were evaluated alone and in combination by the area under receiver operating characteristic curve (AUROC). All fluorescence indicators significantly differed between HCC and BLD and some of them were more valuable for diagnosing HCC than AFP (AUROC 0.782–0.801 vs. 0.752). The diagnostic model established with fluorescence indicators, AFP, hepatic function tests and age showed that AUROC, sensitivity, specificity and accuracy were 0.958 (95% CI 0.936–0.979), 92.0%, 88.9% and 92.3%, respectively, and positive rates in AFP-negative, early and small HCCs were 73.8%, 81.6% and 74.3%, respectively. In conclusion, the combination of dual serum fluorescence, AFP, hepatic function tests and age is simple and valuable for identifying HCC in serum AFP-elevated liver diseases.


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