PLoS One. 2018 Aug 31;13(8):e0203149. doi: 10.1371/journal.pone.0203149. eCollection 2018.
Application of the Doylestown algorithm for the early detection of hepatocellular carcinoma.
Mehta AS1, Lau DT2, Wang M1, Islam A2, Nasir B2, Javaid A2, Poongkunran M2, Block TM3,4.
Author information
1
Department of Cell and Molecular Pharmacology and Experimental Therapeutics, Medical University of South Carolina, Charleston, South Carolina, United States of America.
2
Liver Research Center, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, United States of America.
3
The Baruch Blumberg Institute, Doylestown, Pennsylvania, United States of America.
4
The Hepatitis B Foundation, Doylestown, Pennsylvania, United States of America.
Abstract
BACKGROUND:
We previously developed a logistic regression algorithm that uses AFP, age, gender, ALK and ALT levels to improve the detection of hepatocellular carcinoma (HCC). In 3,158 patients from 5 independent sites, this algorithm, referred to as the "Doylestown" algorithm, increased the AUROC of AFP 4% to 12% and had equal benefit regardless of tumor size or the etiology of liver disease.
AIMS:
Analysis of the Doylestown algorithm using samples from individuals taken before their diagnosis of HCC.
METHODS:
Here, the algorithm was tested using samples at multiple time points from (a) patients with established chronic liver disease, without HCC (120 patients) and (b) 116 patients with HCC diagnosis (85 patients with early stage HCC and 31 patients with recurrent HCC), taken at the time of, and up to 12 months prior to cancer diagnosis.
RESULTS:
Among patients who developed HCC, comparing the Doylestown algorithm at a fixed cut-off to AFP at 20 ng/mL, the Doylestown algorithm increased the True Positive Rate (TPR) in identification of HCC from 36 to 50%, at a time point of 12 months prior to the conventional HCC detection. Similar results were obtained in those patients with recurrent HCC, where the Doylestown algorithm increased TPR in detection of HCC from 18% to 59%, at 12 months prior to detection of recurrence.
CONCLUSIONS:
This algorithm significantly improves the prediction of HCC by AFP alone and may have value in the early detection of HCC.
在开发HCC的患者中，将固定截止值的Doylestown算法与20 ng / mL的AFP进行比较，Doylestown算法将HCC鉴定中的真阳性率（TPR）从36％提高到50％，时间点为传统HCC检测前12个月。在复发性HCC患者中获得了类似的结果，其中Doylestown算法在检测到复发前12个月将HCC检测中的TPR从18％增加到59％。
结论：