Journal of Cancer Research and Clinical Oncology

, Volume 139, Issue 8, pp 1417–1424 | Cite as

A comparison of glypican-3 with alpha-fetoprotein as a serum marker for hepatocellular carcinoma: a meta-analysis

  • Cheng Xu
  • Zhehui Yan
  • Liang Zhou
  • Yuming Wang
Original Paper



Glypican-3(GPC3) has been reported as one of the most promising serum markers for hepatocellular carcinoma (HCC), while several studies have conflicting results for the diagnostic accuracy between GPC3 and alpha-fetoprotein (AFP).


Studies that explored the diagnostic value of GPC3 and AFP in HCC were searched in MEDLINE, EMBASE, PUBMED, the Cochrane Library and Chinese biomedical literature database (CBM). Sensitivity, specificity and other measures about the accuracy of serum GPC3 and AFP in the diagnosis of HCC were pooled using random effects models. Summary receiver operating characteristic curve (sROC) analysis was used to summarize the overall test performance.


Ten studies were included in our meta-analysis. The pooled sensitivity for AFP and GPC3 is 51.9 % (95 % confidence interval (CI) 0.47–0.56) and 59.2 % (95 % CI 0.55–0.63), respectively, while the pooled specificity for AFP and GPC3 is 94 % (95 % CI 92.1–95.6 %) and 84.8 % (95 % CI 82–87.3 %), respectively. The pooled diagnostic odds ratio (DOR) for AFP and GPC3 were 23.4 (95 % CI 10.3–53.2) and 17.99 (95 % CI 5.4–60.4), respectively. Area under sROC for both AFP and GPC3 is 0.81 (95 % CI 0.77–0.84).


GPC3 is comparable to AFP as a serum marker for the diagnosis of HCC, combination of AFP and GPC3 can elevate the sensitivity of diagnosis.


AFP GPC3 Diagnostic accuracy Hepatocellular carcinoma 



This work was supported in part by the State Key Project Specialized for Infectious Diseases (2012ZX10002-004). The funding sources had no role in study design, collection, analysis, or interpretation of data, or the writing of the report; or the decision to submit the report for publication. We declare that we have no conflict of interest to disclose.

Conflict of interest



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Copyright information

© Springer-Verlag Berlin Heidelberg 2013

Authors and Affiliations

  1. 1.Institute of Infectious Diseases, Southwest HospitalThe Third Military Medical UniversityChongqingPeople’s Republic of China
  2. 2.Department of Health StatisticsThe Third Military Medical UniversityChongqingPeople’s Republic of China

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