GPC3 Plus Alpha Fetoprotein Versus Alpha Fetoprotein Alone In The Diagnosis Of Hepatocellular Carcinoma:a Meta-Analysis

?Background?Hepatocellular carcinoma is one of the most common malignant tumors,and its incidence is increasing year by year.With the concealed characteristics and non-specific clinical expression,it has often progressed to the advanced stage and missed the best timing of treatment.Besides,it is easy to recurrence and distant metastasis,and the prognosis is poor.Alpha-fetoprotein(AFP)is the most commonly used screening and diagnosis of hepatocellular carcinoma,but it is poor for sensitivity and specificity.Therefore,some scholars have proposed the combined detection of serum tumor markers in the diagnosis of liver cancer.?Objective ? To investigate the diagnostic value of serum glypican-3(GPC3)combined with alpha-fetoprotein(AFP)versus alpha fetoprotein alone for hepatocellular carcinoma.?Methods?From March 2008 to April 2016,it has been published in the retrieval,such as Pubmed,EMBASE,China biomedical literature database(CBM),China HowNet database(CNKI),VIP journals database,Wanfang database about the diagnostic value of GPC3 combined with AFP compared with AFP alone for hepatocellular carcinoma.The retrieved literatures were screened and selected according to pre-determined inclusion and exclusion criteria.Data were extracted and analyzed using the software Mate-disc 1.4.Summary receiver operating characteristic curve were used to compare test performance of the two.?Results?Sisteen studies were enrolled after full-text evaluation,including ten Chinese literature and six foreign literature.A total of 2602 patients consisting of 1173 HCC patients and 1429 non-HCC patients were eligible in sisteen studies.Heterogeneity existed among these studies.but it was not possibly caused by the threshold effect.Therefore.we used the random effect model for quantitative analysis.The pooled accuracy indicator.sensitivity and specificity with 95% confidence interval(95%)were 0.63(95%CI 0.61-0.66)and 0.87(95%CI 0.85-0.89)for AFP alone,and 0.84(95%CI 0.81-0.86)and 0.81(95%CI 0.79-0.83)for GPC3 combined with AFP.respectively.The area under summary receiver operating characteristics curve and Q index were 0.81 and 0.75 for AFP alone.and 0.92 and 0.85 for GPC3 combined with AFP.?Conclusions?GPC3 combined with AFP significantly improved the diagnostic sensitivity.and its specificity remained at a high level(0.81).And the AUC and Q index of GPC3 combined with AFP were increased compared with the AFP alone.Therefore,before the discovery of more sensitive serum markers for the diagnosis of hepatocellular carcinoma,it is suggested that GPC3 can be combined with AFP to improve the early diagnosis of HCC.