血清AFP，AFP-L3，DCP，GP73和DKK-1的联合检测是否有效提高了肝

StephenW

Do combined assays of serum AFP, AFP-L3, DCP, GP73, and DKK-1 efficiently improve the clinical values of biomarkers in decision-making for hepatocellular carcinoma? A meta-analysis
Yong-Sheng Fang, Qiang Wu, Hong-Chuan Zhao, Yuan Zhou, Lei Ye, Sheng-Sheng Liu, show all
Received 06 Dec 2020, Accepted 05 Mar 2021, Accepted author version posted online: 11 Mar 2021, Published online: 18 Mar 2021

    Download citation https://doi.org/10.1080/17474124.2021.1900731 CrossMark Logo CrossMark


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ABSTRACT

Objectives: Serum biomarkers are valuable for clinical decision-making for patients with hepatocellular carcinoma (HCC), among which the most promising are AFP, AFP-L3, DCP, DKK-1, and GP73; however, the efficacy of using combined biomarkers remains controversial. This meta-analysis provides insights regarding this topic.

Methods: After systematically surveying the literature available in PubMed, Embase, and Cochrane Library, we identified 28 qualified articles published since January 2015. A random-effects model was used to assess pooled sensitivity, specificity, positive and negative likelihood ratios (PLRs and NLPs), and diagnostic odds ratio (DOR).

Results: Values under the summary receiver operating characteristic (SROC) curve varied in different panels of the five biomarkers. Importantly, the sum of sensitivity and specificity of AFP+GP73 was 1.76 (P= 0.0001), which was the best among all the panels. The sum of the triple biomarker panel of AFP, AFP-L3, and DCP was larger (1.64, P= 0.0001) than those of any double biomarker panels of AFP, AFP-L3, and DCP.

Conclusions: To the best of our knowledge, this is the first meta-analysis to focus solely on combination assays of multiple biomarkers in HCC. The combined assay of AFP and GP73 conferred the best outcome among all panels. The triple combined panel of AFP, AFP-L3, and DCP showed higher diagnostic potential than individual random double combinations of the three biomarkers. Multiple-biomarker combined assays will be clinically important for decision-making processes for HCC.

KEYWORDS: Serum biomarkers combined assay hepatocellular carcinoma meta-analysis

StephenW

血清AFP，AFP-L3，DCP，GP73和DKK-1的联合检测是否有效提高了肝癌决策决策中生物标志物的临床价值？荟萃分析
方永生，吴强，赵洪川，周媛，叶蕾，刘胜生，显示全部
于2020年12月6日收到，于2021年3月5日接受，在网上发表的作者版本为2021年3月11日，在线发表的时间为2021年3月18日

    下载引文https://doi.org/10.1080/17474124.2021.1900731 CrossMark徽标CrossMark


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目的：血清生物标志物对肝细胞癌（HCC）患者的临床决策具有重要价值，其中最有前途的是AFP，AFP-L3，DCP，DKK-1和GP73。然而，使用组合生物标志物的功效仍存在争议。这项荟萃分析提供了有关此主题的见解。

方法：在对PubMed，Embase和Cochrane图书馆中的文献进行系统调查之后，我们确定了自2015年1月以来发表的28篇合格文章。使用随机效应模型评估了合并的敏感性，特异性，阳性和阴性似然比（PLR和NLP） ）和诊断几率比（DOR）。

结果：在五个生物标记物的不同面板中，摘要接收器操作特征（SROC）曲线下的值有所不同。重要的是，AFP + GP73的敏感性和特异性之和为1.76（P = 0.0001），在所有面板中均是最好的。 AFP，AFP-L3和DCP的三重生物标志物组的总和比AFP，AFP-L3和DCP的任何双重生物标志物组的总和大（1.64，P = 0.0001）。

结论：就我们所知，这是第一个仅侧重于肝癌中多种生物标志物联合测定的荟萃分析。 AFP和GP73的联合测定在所有小组中均获得了最佳结果。 AFP，AFP-L3和DCP的三联组合面板显示出比三种生物标记物的单个随机双联组合更高的诊断潜能。多种生物标志物联合测定对肝癌的决策过程具有重要的临床意义。

关键词：血清生物标志物联合测定肝细胞癌荟萃分析