A comparison of glypican-3 with alpha-fetoprotein as a serum marker for hepatocellular carcinoma: a meta-analysis
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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.
KeywordsAFP 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
- Bh Y (2001) Chinese society of liver cancer: clinical diagnosis and staging criteria for primary hepatocellular carcinoma. Zhongguo Ganzangbing Zazhi 9:324–330Google Scholar
- Dinnes J et al (2005) A methodological review of how heterogeneity has been examined in systematic reviews of diagnostic test accuracy. Health Technol Assess 9(12):1–113Google Scholar
- Li P et al (2009) Diagnosis of Glypican-3 protein for primary hepatic cancer is superior to alpha-fetoprotein. Hep Intl 3(1):155Google Scholar
- Li P et al (2010) Diagnostic value of serum AFP alone or in combination with glypican 3, VEGF or IGF-II for patients with primary hepatocellular carcinoma. World J GastroenterolGoogle Scholar
- Miao H et al (2007) Glypican-3 protein expression in serum and tissues and its clinical significance in hepatocellular carcinoma. World Chin J Digestol 15(21):2311–2315Google Scholar
- Moety HAAE et al (2011) Glypican-3 amino terminal marker for early detection of HCC. Hep Intl 5(1):435Google Scholar
- Sousa MR, Ribeiro AL (2009) Systematic review and meta-analysis of diagnostic and prognostic studies: a tutorial. Arq Bras Cardiol 92(3): 229–238, 235–245Google Scholar
- Wei Z et al (2007) Detection of glypican 3 in serum and its clinical significance on the diagnosis of hepatocellular carcinoma. Tumor 27(9):679–682Google Scholar
- Youssef MF et al (2010) Clinical utility of Glypican- 3 in hepatocellular carcinoma. Int J Integr Biol 10(1):41–47Google Scholar