Experimental And Clinical Study On The Diagnosis Of Primary Hepatocelluar Carcinoma

Background: DCP is helpful for the diagnosis of hepatocecullar carcinoma (HCC), and regarded as a clinical diagnostic indicator at abroad. Although the difference of the etiology between China and the western countries is obvious, DCP is rarely mentioned in our country.Objective: The aim of this study was to assess the diagnostic value of DCP in HCC in China, and to furtherly compare with AFP.Method: The serum levels of DCP and AFP were measured by ELASA in the patients including 71 cases of hepatocarcinoma, 17 cases of hepato-cirrhosis, 12 cases of chronic hepatitis, 10 cases of other malignant tumors and 10 cases of normal controls. In addition, the serum levels of DCP were measured for the 20 patients treated by VitK 3-5 days later. DCP 40mAU/ml and AFP 20ng/ml were regard as the diagnostic standards of HCC. Immunohistochemistry was performed in tumor and para tumorous tissue of 25 HCC patients, contrasted with 10 tissue of normal liver and 8 pancreatic adenocarcinoma.Results: (1)The DCP concentration in the HCC patients was (3007.3 4268.0 mAU/ml), which was strikingly higher than that in the hepato-cirrhosis, chronic hepatitis, other malignant tumors and normal controls (P<0.01). (2)The DCP concentration of the patients with large HCC tumors (>5cm), multi-tumors and the PVI- positive was significantly higher than that in small tumors ( 3-5cm, <3cm) and the PVI negative ones(P<0.01), The DCP concentration is proportional to the diameter of tumors(P<0.01, P<0.05). (3)The sensitivity and speciality of DCP were 63.4% and 92.2% respectively to the diagnosis of hepacarcinoma, and AFP is 60.6% and 79.5% respectively. The sensitivity and specialuity of DCP combined with AFP is 80.3% and 71.8% respectively, to the small tumors (<3.0cm), the sensitivity increased to 62.5%. (4)The DCP concentration of hepatocarcinomas was not relative todifferatial degree. ㏕he positive rate of DCP of HCC by immunohistochemistry was 68% (17/25), strikingly higher than the para tumorous tissue of HCC (2/5), normal healthy hepato-tissue (0/10) and pancreatic adenocarcinoma (0/8)(P<0.01). The positive rate was not relative to the DCP concentration.Conclusion: DCP is a good diagnostic marker of hepatocarcinoma in China. The combination of DCP and AFP can increase the sensitivity to diaguosis HCC, especially to small hepatocarcinoma. The concentration of DCP is also helpful to judge the size of tumors and the possibility of the portal vein invation. DCP is one reliable index of immunohistochemistry.