Application Value Of Serum DCP,AFP,AFP-L3 And HSP90α In Diagnosis Of Hepatocellular Carcinoma

Objective In this study,DCP,AFP,AFP-L3,AFP-L3%and HSP90α levels in serum of patients with hepatocellular carcinoma(HCC)were detected to evaluate the value of their independent and combined detection in the auxiliary diagnosis of HCC patients.Methods According to the inclusion and exclusion criteria,50 HCC patients treated in our hospital from October 2021 to June 2022 were selected as the HCC group,30 patients with decompensated cirrhosis(DCC),30 patients with chronic viral hepatitis B(CHB),and 30 healthy subjects were selected as the control group.Serum levels of DCP,AFP,AFP-L3,AFP-L3% and HSP90α were determined by enzyme-related immunosorbent assay.ROC curve was drawn to compare the diagnostic value of serum AFP-L3,AFP-L3%,HSP90α and GALAD score,and area under the curve(AUC),sensitivity,specificity,Yoden index and optimal threshold value were calculated.ROC curve was drawn to analyze the diagnostic value of combined detection of DCP,AFP,HSP90α and GALAD score for HCC.Fifty HCC patients were divided into hepatitis B virus(HBV)positive and HBV negative subgroups,AFP positive and AFP negative subgroups,early HCC subgroup and middle and late HCC subgroup.ROC curve was drawn to compare the diagnostic value of serum DCP,AFP,AFP-L3,AFP-L3%,HSP90α levels and GALAD scores in different HCC subgroups.Results 1.The serum levels of AFP,AFP-L3,AFP-L3%,DCP,HSP90α and GALAD score in HCC group were significantly higher than those in the other three groups,with statistical significance(P < 0.05).2.The levels of serum AFP,AFP-L3,AFP-L3%,DCP,HSP90α and the AUC of GALAD score were(0.804)VS(0.680)VS(0.685)VS(0.870)VS(0.825)VS(0.938),respectively.The GALAD score had the highest AUC value(0.938)and sensitivity(88%).The specificity of DCP and AFP-L3 was the highest(96.7%).3.The diagnostic efficacy of AFP-L3 and AFP-L3% was low.After removing them,the predictive probability values of pduo or combined diagnosis of the other three serum indicators were calculated by binary logistic regression,and the ROC curve was analyzed again.The specificity,sensitivity and AUC of AFP combined with HSP90αfor HCC were 92.2%,80.0% and 0.867 respectively.The sensitivity,specificity and AUC of AFP and DCP combined with HSP90α were 90.0%,90.0% and 0.915 respectively.GALAD score combined with HSP90α had the highest AUC(0.940),sensitivity(88.0%)and specificity(91.1%).4.The levels of AFP,AFP-L3,AFP-L3%,DCP,HSP90α and GALAD score in HBV positive and HBV negative subgroups were higher than those in non-HCC group,and the difference was statistically significant(P < 0.05).The ROC curves of the two subgroups were compared with those of the non-HCC group.The highest AUC value in the HBV positive subgroup was GALAD(0.947),the highest sensitivity(88.2%)and the highest specificity(97.8%)in the diagnosis of HCC.The highest AUC in HBVnegative subgroup was GALAD score(0.918),and the highest sensitivity(87.5%)and specificity(91.1%)in diagnosing HCC.5.The levels of serum AFP,AFP-L3,AFP-L3% and GALAD score of AFP positive subgroup were higher than those of AFP negative subgroup,with statistical significance(P < 0.05).The ROC curves of the two groups were compared with those of the nonHCC group.Except for AFP,GALAD score(0.990)was the highest in the AFP positive group,and the sensitivity of HCC diagnosis was as high as 100%.The highest specificity was DCP and AFP-L3(97.8%).In the negative AFP subgroup,the highest AUC value was DCP and GALAD score(0.872),and the highest sensitivity was DCP(77.3%).The highest specificity was HSP90α(94.4%).6.The GALAD score of early HCC subgroup was lower than that of middle and late HCC subgroup,and the difference was statistically significant(P < 0.05).ROC curves of the two groups were compared with those of the non-HCC group.GALAD score was the highest in the early HCC group(0.917).The sensitivity of GALAD score and AFP in diagnosing HCC was the highest(81.8%).The highest specificity was HSP90α(97.8%).GALAD score(0.994)and sensitivity(89.7%)were the highest in HCC subgroup.DCP had the highest specificity(97.8%).Conclusion Serum DCP,AFP-L3,AFP-L3% and HSP90α can all be used as tumor markers for HCC.The diagnostic efficacy of DCP and HSP90α is higher than that of traditional tumor markers AFP,but the specificity of HSP90α is relatively low.The diagnostic efficacy of GALAD score was higher than that of any single serological index.The combined diagnosis of all serological indexes greatly improves the diagnostic sensitivity,can improve the diagnostic sensitivity of HCC,improve the positive rate of HCC screening,and has a high value of clinical promotion.GALAD score still has a good diagnostic efficacy in patients with HBV positive,AFP negative and early HCC,which is widely promoted in our country with HBV infection as the background,and can be used to compensate the situation that AFP alone is easy to miss early HCC.