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Disease Markers
Volume 32 (2012), Issue 4, Pages 265-271
http://dx.doi.org/10.3233/DMA-2011-0878

Combined Analysis of AFP and HCCR-1 as an Useful Serological Marker for Small Hepatocellular Carcinoma: A Prospective Cohort Study

Guoxin Zhang,1 Seon-Ah Ha,2 Hyun K. Kim,2 Jinah Yoo,2 Sanghee Kim,2 Youn S. Lee,3 Soo Y. Hur,4 Yong W. Kim,4 Tae E. Kim,4 Yong G. Park,5 Jing Wang,1 Yang Yang,1 Zekuan Xu,1 Eun Y. Song,6 Zuhu Huang,1 Peng Jirun,7 Jin Zhongtian,7 Qiao Shishi,7 Cui Zhuqingqing,7 Gong Lei,7 and Jin W. Kim2,4

1Department of Gastroenterology, the First Affiliated Hospital of Nanjing Medical University, Nanjing, China
2Department of Molecular Genetic Laboratory, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
3Department of Clinical Pathology, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
4Department of Obstetrics and Gynecology, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
5Department of Biostatistics, College of Medicine, the Catholic University of Korea, Seoul, Republic of Korea
6The Korea Research Institute of Bioscience and Biotechnology, Daejeon, Republic of Korea
7Department of Hepatobiliary, Surgery, Peking University People’s Hospital, Beijing, China

Received 15 March 2012; Accepted 15 March 2012

Copyright © 2012 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Hepatocellular carcinoma (HCC) is one of the most frequent malignant tumors in the world. The only serological marker widely used for the diagnosis of HCC is alpha-fetoprotein (AFP). Despite that AFP is widely used for the diagnosis of HCC, it has a limit as a serological marker due to its low sensitivity and specificity. The human cervical cancer proto-oncogene 1 (HCCR-1) was previously reported as a new biomarker for HCC. To further evaluate the HCCR-1 as a biomarker for HCC, we conducted the prospective cohort study. We evaluated the significance of simultaneous measurement of 2 tumor markers in the diagnosis of HCC in China, Japan and Korea. Two markers for HCC, AFP and HCCR-1, were measured in the sera obtained from 1,338 patients at the time of initial diagnosis of HCC. Of the 1338 HCC patients, 616 (46%) and 686 (51.3%) were sero-positive for AFP and HCCR-1, respectively. The positive rate for HCC was increased up to 74.1% in combined use of AFP and HCCR-1. Many cases (54%) for AFP-negative HCC were positive for HCCR-1 and vice versa. More importantly, the diagnostic rate for small HCC (< 2 cm) was significantly improved in the combined analysis of AFP and HCCR-1 to 56.9% although it was only 40.1% and 23.4% in the single analysis of HCCR-1 and AFP, respectively. Our result suggests that the HCCR-1 could be an useful biomarker for HCC while the diagnostic rate could be significantly improved in the combined use of HCCR-1 and AFP.