Diagnostic Value of Serum Biomarkers for Patients Undergoing Curative Resection with Non-B, Non-C Hepatocellular Carcinoma

Objective: To determine the diagnostic value of alpha-fetoprotein (AFP) and des-gamma-carboxy prothrombin (DCP) for patients with non-B, non-C hepatocellular carcinoma (NBNC HCC). Study Design: Observational study. Place and Duration of Study: The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China, from June 2016 to June 2019. Methodology: Patients with NBNC HCC diagnosed by histology were inducted after curative resection. Serum levels of AFP and DCP were determined. Their receiver operating characteristic (ROC) curves were generated, and the area under the ROC curve (AUC) calculated. In subgroup analyses involving patients with hepatitis B core antibody (HBcAb) testing, the AUC of AFP and DCP were also calculated and compared. Results: Serum levels of AFP and DCP were clearly increased in the NBNC HCC group relative to controls (p = 0.000 for both). The AUC for AFP, DCP and their combination (AFP+DCP) were 0.763 (95%CI: 0.712-0.814), 0.853 (95%CI: 0.811-0.894), and 0.867 (95%CI: 0.829-0.906), respectively. For HBcAb-positivity, the AUC of AFP and DCP were 0.7517 (95%CI: 0.6917-0.8116) and 0.8469 (95% CI: 0.7985-0.8963), respectively. For HBcAb-negativity, the AUC of AFP and DCP were 0.8083 (95%CI: 0.6993-0.9174) and 0.8740 (95%CI: 0.7901-0.9580), respectively. Conclusion: A combination of AFP and DCP is useful for assisting the diagnosis of NBNC HCC before surgery. AFP and DCP showed better diagnostic accuracy for HBcAb-negativity compared with HBcAb-positivity in NBNC HCC patients.