Development of a diagnostic nomogram for alpha-fetoproteinnegative hepatocellular carcinoma based on serological biomarkers  

作　　者：Li He Cui Zhang Lan-Lan Liu Li-Ping Huang Wen-Jing Lu Yuan-Yuan Zhang De-Yong Zou Yu-Fei Wang Qing Zhang Xiao-Li Yang 

机构地区：[1]School of Clinical Medicine,Weifang Medical University,Weifang 261053,Shandong Province,China [2]Department of Organ Transplantation,The Third Medical Centre of Chinese PLA General Hospital,Beijing 100039,China [3]Department of Laboratory Medicine,The Third Medical Centre of Chinese PLA General Hospital,Beijing 100039,China [4]Department of Laboratory Medicine,Jingyu County People’s Hospital,Baishan 135200,Jilin Province,China [5]School of Laboratory Medicine,Weifang Medical University,Weifang 261053,Shandong Province,China

出　　处：《World Journal of Gastrointestinal Oncology》2024年第6期2463-2475,共13页世界胃肠肿瘤学杂志（英文版）（电子版）

基　　金：Supported by National Natural Science Foundation of China,No.81972696.

摘　　要：BACKGROUND Hepatocellular carcinoma(HCC)is the third leading cause of cancer-related death worldwide.Serum biomarkers play an important role in the early diagnosis and prognosis of HCC.Because a certain percentage of HCC patients are negative for alpha-fetoprotein(AFP),the diagnosis of AFP-negative HCC is essential to improve the detection rate of HCC.AIM To establish an effective model for diagnosing AFP-negative HCC based on serum tumour biomarkers.METHODS A total of 180 HCC patients were enrolled in this study.The expression levels of GP73,des-γ-carboxyprothrombin(DCP),CK18-M65,and CK18-M30 were detected by a fully automated chemiluminescence analyser.The variables were selected by logistic regression analysis.Several models were constructed using stepwise backward logistic regression.The performance of the models was compared using the C statistic,integrated discrimination improvement,net reclassification improvement,and calibration curves.The clinical utility of the nomogram was assessed using decision curve analysis(DCA).RESULTS The results showed that the expression levels of GP73,DCP,CK18-M65,and CK18-M30 were significantly greater in AFP-negative HCC patients than in healthy controls(P<0.001).Multivariate logistic regression analysis revealed that GP73,DCP,and CK18-M65 were independent factors for diagnosing AFP-negative HCC.By comparing the diagnostic performance of multiple models,we included GP73 and CK18-M65 as the model variables,and the model had good discrimination ability(area under the curve=0.946)and good goodness of fit.The DCA curves indicated the good clinical utility of the nomogram.CONCLUSION Our study identified GP73 and CK18-M65 as serum biomarkers with certain application value in the diagnosis of AFP-negative HCC.The diagnostic nomogram based on CK18-M65 combined with GP73 demonstrated good performance and effectively identified high-risk groups of patients with HCC.

关 键 词：Hepatocellular carcinoma Alpha-fetoprotein-negative DIAGNOSTIC NOMOGRAM Biomarker 

分 类 号：R735.7[医药卫生—肿瘤]