Simple screening method for the diagnosis of nonB-nonC hepatocellular carcinoma

Abstract

Aim: The incidence of non-virus-related nonB-nonC hepatocellular carcinoma (NBNC-HCC) is on the rise. However, screening at-risk individuals using imaging methods is complicated by the large size of the at-risk patient pool. The aim of this study is to develop an effective simple screening method, using blood tests. Methods: The diagnostic value of aspartate aminotransferase (AST), alpha-fetoprotein (AFP), and des-gammacarboxy prothrombin (DCP) was analyzed using sera from 203 NBNB-HCC patients and 106 diabetes mellitus patients. Results: Areas under receiver operating characteristic curves for AST, AFP, and DCP were 0.844, 0.901, and 0.914, respectively. The optimal cutoffs for diagnosing NBNC-HCC based on Youden indices were 30 IU/L, 3.6 ng/mL, and 25 mAU/mL, respectively. On selecting patients who were positive at least one parameter (AST, AFP, or DCP), the sensitivity was 97.5%. This high sensitivity was preserved (98.0%) even in cases of nonadvanced HCC (≤ 3 cm, ≤ 3 nodules). Specificity was 72.6%. Conclusion: This simple triple screen for AST, AFP, and DCP appears to have diagnostic value in NBNC-HCC and could be used to select candidates for further testing using imaging.