Quick Summary

Serum biomarkers are valuable for clinical decision-making for patients with hepatocellular carcinoma (HCC), among which the most promising are AFP, AFP-L3, DCP, DKK-1, and GP73; however, the efficacy of using combined biomarkers remains controversial. This meta-analysis provides insights regarding this topic.

 

PubMed, Embase, and Cochrane Library were systematically surveyed, and 28 qualified articles published since January 2015 were identified. A random-effects model was used to assess pooled sensitivity, specificity, positive and negative likelihood ratios (PLRs and NLPs), and diagnostic odds ratio (DOR).

Quick Summary

There is controversy regarding the overall value of hepatocellular carcinoma (HCC) surveillance in patients with cirrhosis given the lack of data from randomized-controlled trials. To address this issue, a systematic review and meta-analysis of cohort studies evaluating the benefits and harms of HCC surveillance in patients with cirrhosis was conducted.

 

A search of the Medline and EMBASE databases and national meeting abstracts were performed for studies reporting early-stage HCC detection, curative treatment receipt, or overall survival, stratified by HCC surveillance status, among patients with cirrhosis, from January 2014 through July 2020. Pooled risk ratios (RRs) and hazard ratios, according to HCC surveillance status, were calculated for each outcome using the DerSimonian and Laird method for random effects models.

Meta-analysis to evaluate the performance & diagnostic value of AFP and PIVKA-II across different HCC risk factors

Quick Summary

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.

Meta-analysis of biomarkers for HCC diagnosis, including AFP, DCP (PIVKA-II), GPC3, GP73, Hsp90alpha, midkine, and OPN

Quick Summary

Hepatocellular carcinoma lacks ideal diagnostic biomarkers. There is a lack of scientific evaluation of relevant promising biomarkers as well. Therefore this study reanalyzes the related studies of 11 blood biomarkers of HCC, and compares the diagnostic value of these biomarkers for HCC systematically.

The authors found that the combination of AFP and other biomarkers improved the diagnostic efficiency. The diagnostic value of biomarkers including DCP (PIVKA-II), GPC3, GP73, Hsp90alpha, midkine, and OPN was higher than that of AFP. GP73 had the best diagnostic value for HCC.

Quick Summary

This study compares the diagnostic capability of Protein induced by vitamin K absence or antagonist-II (PIVKA-II) with alpha-fetoprotein (AFP) for hepatocellular carcinoma (HCC). The study conducted a systematic literature search to identify relevant studies published up to December 20, 2017. A total of 31 studies were included, and the data were analyzed using a random effects model. This meta-analysis indicates that PIVKA-II is better than AFP in terms of the accuracy for diagnosing HCC, regardless of tumor size, patient ethnic group, or HCC etiology.