Serum Biomarkers AFP, CEA And CA199Combined Detection For Early Diagnosis Of Hepatocellular Carcinoma

AIM:To clarify the value of combined use of serum biomarkers for the diagnosis of hepatocellular carcinoma.METHODS:Serum alpha Fetoprotein (AFP), cancer antigens (CA19-9), and carcinoembryonic antigen (CEA) levels were retrospectively evaluated in1075patients diagnosed with primary hepatocellular carcinoma (PHC),237patients with Liver cirrhosis, and50healthy controls. AFP, CA19-9and CEA levels and positive rates were analyzed and evaluated and the sensitivity and specificity of the serum markers in hepatocellular carcinoma were calculated along with the positive and negative predictive values.RESULTS:Serum AFP, CEA, and CA19-9levels in the PHC group were significantly higher when compared with those in the liver cirrhosis and healthy control groups (P<0.05). With AFP as a single tumor marker for PHC diagnosis, the sensitivity of AFP was the highest (63.3%) with a specificity of80.8%. The positive and Negative Predictive Values were92%and37%respectively. The highest specificity was obtained when AFP was combined with Ca19-9and CEA, specificity being100%but the sensitivity was too low, only2.5%and the Positive and Negative predictive values were100%and22%respectively. Diagnostic accuracy was highest with AFP only. Thus, combination of CA19-9and CEA with AFP could not provide a better diagnostic tool for the early diagnosis of Hepatocellular carcinoma.CONCLUSION:AFP, CA19-9and CEA combined detection, though it has a specificity of100%and a positive predictive value of100%but its sensitivity is very low. Hence, in clinical practice its use to diagnose primary Hepatocellular Carcinoma has no strong significance as compared to the clinical significance of AFP alone.