The Diagnostic Significance Of Serum OPN And AFP-L3% For Primary Hepatocellular Carcinoma With Low Concentration Of AFP

Objective To study the expression of serum OPN in primary hepatocellular carcinoma;to explore the significance of serum OPN and AFP-L3% in the diagnosis of primary hepatocellular carcinoma with low concentration of AFP.Methods A total of 120 research subjects were included in this study,divided into 4groups: primary hepatocellular carcinoma group,hepatitis cirrhosis group,chronic viral hepatitis group,and healthy control group,each with 30 cases.Peripheral blood was drawn and used chemiluminescence method,microcentrifuge column method,enzyme-linked immunosorbent assay method to check the serum AFP,AFP-L3 and OPN concentrations of all subjects,and calculated the ratio of AFP-L3 in total AFP as AFP-L3%.We compared the expression differences of serum OPN among the groups and analyzed the correlation between OPN and AFP and AFP-L3 expression,evaluated the significance of three indicators of AFP,AFP-L3%,and OPN respectively and combined in the diagnosis of PHC,compared the significance of OPN and AFP-L3% in the diagnosis of primary hepatocellular carcinoma with low concentration of AFP.Results First.The concentrations of serum AFP,AFP-L3%,and OPN were the highest in the primary hepatocellular carcinoma group;followed by the hepatitis cirrhosis and chronic viral hepatitis group.There were significant differences(P<0.05).Second.The serum concentration of OPN in the primary hepatocellular carcinoma group,hepatitis cirrhosis group,and chronic viral hepatitis group were not correlated with the serum concentration of AFP and AFP-L3%(P>0.05).Third.When the three indicators of serum AFP,AFP-L3%,and OPN were tested separately,the sensitivity for the diagnosis as primary hepatocellular carcinoma was 70%,53.3%,and 96.7%,and the specificity was 97.8%,91.1%,and 60.0 %.The area under the ROC curve was 0.891(95%CI: 0.810～0.971),0.777(95%CI: 0.679～0.841),0.874(95%CI: 0.807～0.941).When these three indicators were combined for the diagnosis as PHC,the sensitivity was 80.0%,the specificity was 88.9%,and the area under the ROC curve was 0.901(95%CI: 0.844～0.958).Fourth.Separately detection of OPN and AFP-L3% in patients with hepatic cancer with low concentration of AFP(AFP<200ng/ml)for the diagnosis as PHC,the sensitivity respectively was100%,100%,and the specificity respectively was 5.9%,11.8 %,and the area under the ROC curve respectively was 0.267(95%CI: 0.086～0.44)and 0.308(95%CI: 0.108～0.508).When both were detected at the same time for diagnosing hepatic cancer patients with low concentration of AFP,the sensitivity was 100%,the specificity was 70.6%,and the area under the ROC curve was 0.932(95% CI: 0.849～1).Conclusions First.Serum marker of AFP,AFP-L3% and OPN could be used for auxiliary diagnosis as primary hepatocellular carcinoma.Combination of these indicators could improve the early detection rate of primary hepatocellular carcinoma.Second.Serum OPN concentration was not affected by AFP and AFP-L3% concentration.OPN had diagnostic significance for primary hepatocellular carcinoma with low concentration of AFP.The combined detection of serum OPN and AFP-L3% can significantly improve the sensitivity of the diagnosis of primary hepatocellular carcinoma with low concentration of AFP,which was helpful for early screening of primary hepatocellular carcinoma.Third.OPN may be used as an early warning indicator of PHC.Monitoring the serum OPN level in high-risk patients such as patients with liver cirrhosis may increase the early detection rate of liver cancer.