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This meta-analysis aimed to clarify the diagnostic value of these two serum markers in patients with different risk of HCC development, such as etiology, ethnicity, and various stages of tumor. The impact of varying study types of literature and detection methods of index test on the diagnosis outcome was also explored, providing evidence for the two serum markers in the clinical management of patients at risk of tumor development.

The authors found that overall, the diagnostic accuracy of DCP (PIVKA-II) was superior to AFP. However, the diagnostic performance of AFP and DCP (PIVKA-II) was different in different ethnicity, etiology, and detection methods. The authors concluded that the combination of DCP (PIVKA-II) and AFP can improve the effectiveness of surveillance for patients at risk of HCC.