Evaluation of AFP, AFP-L3%, and DCP in the diagnosis and after surgery prognosis of HCC

Abstract Background To investigate the prognostic value of alpha-fetoprotein (AFP), ratio (AFP-L3%), and Des-γ-carboxyprothrombin (DCP) in the diagnosis and surgical resection of hepatocellular carcinoma (HCC). Methods Normal physical examiners were used as the control group, and the group of HCC patients admitted to our hospital was subdivided into HCC before treatment (HCC-BT) and HCC after excisional surgery (HCC-AS), based on the results of serum AFP, AFP-L3% and DCP assays. The diagnostic value of AFP, AFP-L3%, DCP, and their combinations in the diagnosis of HCC and prognosis of HCC after excisional surgery were compared and analyzed by applying the subject's receive operating characteristic (ROC) and area under the curve (AUC). Results There were 150 cases in the control group and 227 cases in the patient group, of which 89 and 138 cases were HCC-BT and HCC-AS, respectively (35 cases had recurred or new lesions were seen again), and the detection results of all indexes were statistically significant. ROC curve analysis showed that AFP, AFP-L3%, DCP, and their combinations showed a large difference in distinguishing HCC-BT from HCC-AS. AFP, AFP-L3%, and DCP had a high diagnostic value for screening HCC-BT, and DCP was slightly better than AFP and AFP-L3%, with a corresponding AUC of 0.74. When compared to normal controls, DCP, AFP, and AFP-L3% had no diagnostic significance for HCC-AS. Based on the temporary absence of recurrence after surgery as a control, DCP, AFP, and AFP-L3% again showed some prognostic value, and DCP was slightly better than AFP and AFP-L3%, with a corresponding AUC of 0.744. Conclusion In the diagnosis of HCC-BT, AFP, DCP and their combinations have high diagnostic values, and the combined test of the two has higher diagnostic value. In terms of HCC-AS prognosis, both AFP and DCP can be used as the main indicators of prognosis, but it is appropriate to establish new diagnostic criteria.