A threshold analysis of alpha-fetoprotein in diagnosis and screening of hepatocellular carcinoma
10.3969/j.issn.1001-5256.2018.11.016
- VernacularTitle:甲胎蛋白诊断和筛查原发性肝癌的阈值分析
- Author:
Zhou TIAN
1
;
Jianhuai ZHANG
Author Information
1. Nanjing Medical University, Nanjing 210000, China
- Publication Type:Research Article
- Keywords:
alpha-fetoproteins;
liver neoplasms;
reference values;
diagnosis;
mass screening
- From:
Journal of Clinical Hepatology
2018;34(11):2352-2355
- CountryChina
- Language:Chinese
-
Abstract:
ObjectiveTo investigate the optimal cut-off value of alpha-fetoprotein (AFP) in the diagnosis and early screening of hepatocellular carcinoma (HCC). MethodsThe clinical data of 2212 HCC patients who were diagnosed and hospitalized in our hospital and 1998 non-HCC patients were collected, and the AFP level was summarized. The AFP level was divided into 10 ranges of 10-20 μg/L, 21-65 μg/L, 66-110 μg/L, 111-155 μg/L, 156-200 μg/L, 201-250 μg/L, 251-300 μg/L, 301-350 μg/L, 351-400 μg/L, and ＞400 μg/L, and a comparative analysis was performed for the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of each cut-off value of AFP, ultrasound, and their combination in the diagnosis of HCC. The receiver operating characteristic (ROC) curve was plotted to determine the optimal cut-off value. ResultsThe cut-off valve of AFP of 200-250 μg/L had the largest sum of sensitivity and specificity (1.370 1) and the largest area under the ROC curve (0.896 4). AFP ＞20 μg/L combined with ultrasound had the highest sensitivity (95.35%) in the diagnosis of HCC, with a diagnostic odds ratio of 26.13. ConclusionThe optimal cut-off value of AFP in the diagnosis of HCC is 200 μg/L. When AFP combined with ultrasound is used for the screening of people at a high risk of HCC, AFP＞20 μg/L is recommended as a positive index, and its combination with differential diagnosis and close follow-up and examinations can reduce the false negative rate of screening.
