Clinical significance of serum GP73，AFP-L3 test in the diagnosis of primary hepatic carcinoma with low concentration of alpha-fetoprotein

Abstract:

Objective：To investigate the value of serum Glogi glycoprotein 73（GP73） and alpha-fetoprotein-L3（AFP-L3） in the di－agnosis of primary hepatic cancer（PHC） exhibiting low levels of alpha-fetoprotein（AFP）（AFP<108.0 μg/L）. Methods：Totally 50 cases of PHC with low levels of AFP，60 cases of non-PHC digestive system disorders（20 cases of hepatitis，20 cases of liver cirrhosis and 20 cases of malignant tumors of digestive system） and 40 cases of healthy controls were collected. Serum GP73 was analyzed by enzyme-1inked immunosorbent assay. AFP-L3 was separated by microspincolumn. Levels of AFP-L3 and AFP were quantified by electrochemiluminescence immunoassays. Percentage of AFP-L3 in total AFP was calculated. Different indicators among groups were compared. Results：Level of serum GP73 was higher in PHC patients（105.4 μg/L） than in non-PHC patients with digestive system disorders（39.7 μg/L） and healthy controls（19.3 μg/L）（all P<0.01）. Level of AFP-L3（%） was higher in PHC patients（15.6%） than in non-PHC patients with digestive system disorders（9.5%） and healthy controls（9.4%）（P<0.01）. Positive detection rates of GP73 and AFP-L3（%） in PHC group was higher than those in other groups（P<0.01）. Sensitivity，specificity and accuracy rates in the diag－nosis of PHC by GP73 alone were 74.0%，96.0% and 88.7% respectively，while those via AFP-L3（%） alone were 62.0%，93.0% and 82.7% correspondingly. Areas under ROC analysis curve were 0.828 and 0.778. In the combined detection，the highest sensitivity of GP73 or AFP-L3（%） positive diagnosis was 80.0% and the highest sensitivity of GP73 and AFP-L3（%） positive diagnosis was （100.0%）. Conclusions：Both GP73 and AFP-L3 are effective tumor biomarkers to aid the diagnosis of PHC with low levels of AFP and their combination significantly improves the diagnosis of PHC.