Ultrasound more effective than α-fetoprotein and des-γ-carboxy prothrombin levels-- A. Agrawal, PhD
Wednesday, February 24, 2010 (Last Updated: 02/25/2010)
WEDNESDAY, Feb. 24 (HealthDay News) -- Two biomarkers are less effective than ultrasound in detecting early liver cancer in high-risk patients with advanced hepatitis C, according to a study in the February issue of Gastroenterology.
Anna S. Lok, M.D., from the University of Michigan Medical Center in Ann Arbor, and colleagues measured serum levels of α-fetoprotein (AFP) and des-γ-carboxy prothrombin (DCP) in 39 patients with advanced hepatitis C and hepatocellular carcinoma (HCC) and 77 matched controls without cancer starting a year before diagnosis up to diagnosis.
Using a cutoff of 40 mAU/mL for DCP, the researchers found that the sensitivity was 74 percent at diagnosis and 43 percent a year before diagnosis, while the specificity was 86 and 94 percent, respectively. Using a cutoff of 20 ng/mL for AFP, the sensitivity was 61 percent at diagnosis and 47 percent a year before diagnosis, while the specificity was 81 and 75 percent, respectively. Using both markers, sensitivity improved to 91 percent at diagnosis and 73 percent a year before diagnosis; however, specificity fell to 74 and 71 percent, respectively. Surveillance ultrasound was most effective in detecting early HCC.
"Biomarkers are needed to complement ultrasound in the detection of early HCC, but neither DCP nor AFP is optimal," Lok and colleagues conclude. "Until better serum markers are available, ultrasonography remains the preferred tool for HCC surveillance, but reliable biomarkers to complement ultrasound may improve the detection of early HCC in clinical practice, in which setting interpretation of ultrasound is variable."
The study was partially funded by Eisai and Hoffmann-La Roche through agreements with the National Institutes of Health. Several authors reported consulting and financial relationships with both companies.
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