Diapositiva 1

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Presented at Annual Meeting of American
Association for the Study of Liver Disease,
Boston, Oct 2007
SERUM EXPRESSION OF LECTIN REACTIVE
ALPHA-FETOPROTEIN, DES-GAMMA-CARBOXY
PROTHROMBIN, GOLGI PROTEIN-73 ANTIGEN AND
ANTIBODY, FOR THE DIAGNOSIS OF HEPATOCELLULAR
CARCINOMA
A. Sangiovanni1, G. L. Norman2, Z. Shums2, R.
Romeo1, G. Prati1, M.A. Manini1, M. Iavarone1,
G. Ronchi1, M. Colombo1 1Division of
Gastroenterology 1, IRCCS Maggiore Hospital,
Fondazione Policlinico, Mangiagalli, Regina
Elena, University of Milan, Milan, Italy 2INOVA
Diagnostics, Inc., San Diego, CA, USA.
Background Serum expression of alpha-fetoprotein
(AFP), lectin-reactive alpha-fetoprotein
(AFP-L3), Golgi protein-73 (GP73) antigen, and
des-gamma-carboxy prothrombin (DCP), are known to
be useful tumor markers for the diagnosis of
hepatocellular carcinoma (HCC). Antibodies to
GP73, never before described, were also examined
for potential clinical utility. Aim To define
the diagnostic efficacy of AFP-L3, GP73 antigen,
GP73 antibody, and DCP in differentiating HCC
from chronic liver diseases. Results 51 sera
of patients with chronic hepatitis, 45 with
cirrhosis, and 107 with HCC (54 monofocal, and 53
multifocal), were tested in duplicate for all the
markers. Mean value of DCP, was 0.10.3 AU/mL,
AFP ng/ml 3.42.5 , AFP-L3 gt10 of total 0.20.1,
GP73 Ag 0.90.1 O.D., GP73 Ab 1.60.2 O.D., for
chronic hepatitis, 0.51.0, 29.076.9, 0.41.1,
0.80.2, 1.70.3 respectively for cirrhosis,
78.3492.6, 3761714, 8.918.8, 0.70.2, 1.80.4
respectively for HCC. By univariate analysis
(Mann-Whitney test), DCP (plt0.05) and AFP
(plt0.0005) were significantly higher in cirrhosis
than in chronic hepatitis, while DCP (plt0.0001),
AFP (plt0.0001), GP73 Ab (p0.0002), AFP-L3
(p0.01) were significantly higher, and GP73 Ag
(plt0.0001) significantly lower in HCC than in
cirrhosis. By logistic regression analysis DCP
(O.R. 1.7, C.I. 1.1-2.6, p0.02), GP73 Ab (O.R.
23.6, C.I. 4.0-140.9, p0.001), and GP73 Ag (O.R.
0.0003, C.I. 0.00009-0.01, plt0.0001), were
associated to diagnosis of HCC. When these three
markers were combined together in a new variable,
considered positive when at least one marker had
a value above the 66.6th percentile, the
sensitivity was 91, specificity 78, positive
predictive value 90, negative predictive value
77, positive likelihood ratio 4.0, and negative
likelihood ratio 0.12, and the area under ROC
curve 0.9094. Conclusions Higher expression of
serum DCP and GP73 antibody, and low expression
of GP73 antigen are new promising markers for the
diagnosis of HCC. Combination of these markers
provides a useful non-invasive method for the
diagnosis of HCC.
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Potential conflict of interest G.L. Norman and
Z. Shums are employees of INOVA Diagnostics, Inc.
and have no stock or ownership in the Company
Other Authors have nothing to report