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Clinical Evaluation of Serum Alpha-Fetoprotein-IgM Immune Complexes on the Diagnosis of Primary Hepatocellular Carcinoma

Jiang, Jingting; Wu, Changping; Xu, Ning LU ; Yibei, Zhu; Jun, Wu; Mei, Ji; Bin, Xu; Nilsson-Ehle, Peter LU and Zhang, Xueguan (2009) In Journal of Clinical Laboratory Analysis 23(4). p.213-218
Abstract
We evaluated clinical significance of serum alpha-fetoprotein (AFP)-IgM immune complexes, in comparison with free AFP, on the diagnosis of primary hepatocellular carcinoma (HCC). Serum levels of AFP-IgM immune complexes and free AFP were determined by the ELISA method and electrochemiluminescence, respectively, in 103 healthy controls, 74 patients suffering from primary HCC, 27 patients suffering from liver cirrhosis, and 63 patients suffering from chronic hepatitis. The best cut-off value of AFP-IgM and free AFP for diagnosis of primary HCC were 300 AU/mL and 10 mu g/L respectively, according to the area under the curve (AUC) in this study. The sensitivity of AFP-IgM and free AFP were 64.9 and 79.7%, and the specificity were 75.6 and... (More)
We evaluated clinical significance of serum alpha-fetoprotein (AFP)-IgM immune complexes, in comparison with free AFP, on the diagnosis of primary hepatocellular carcinoma (HCC). Serum levels of AFP-IgM immune complexes and free AFP were determined by the ELISA method and electrochemiluminescence, respectively, in 103 healthy controls, 74 patients suffering from primary HCC, 27 patients suffering from liver cirrhosis, and 63 patients suffering from chronic hepatitis. The best cut-off value of AFP-IgM and free AFP for diagnosis of primary HCC were 300 AU/mL and 10 mu g/L respectively, according to the area under the curve (AUC) in this study. The sensitivity of AFP-IgM and free AFP were 64.9 and 79.7%, and the specificity were 75.6 and 80.3%, respectively, when all cases of primary HCC were analyzed, and the AUC of free AFP was larger than that of AFP-IgM (0.85 vs. 0.72, Z = 3.21). However, in case of primary HCC at early stages (stages I and II) were analyzed, the AUC of AFP-IgM was larger than that of free AFP (0.91 vs. 0.82, Z = 1.73), which demonstrated that the sensitivity of AFP-IgM and free AFP were 94.4 and 72.2%, and the specificity were 81.9 and 79.9%, respectively. When both AFP-IgM and free AFP were positive, the specificity of diagnosis of primary HCC was 89.1%, and the efficacy was 79.0%. It is concluded that either sensitivity or specificity of serum level of AFP-IgM immune complexes was higher than that of free AFP in the diagnosis of primary HCC at early stages. As there was false positive AFP-IgM existed in the patients suffering from cirrhosis and chronic hepatitis, the combination of free AFP and AFP-IgM could significantly increase specificity and decrease false negative and/or false positive in the primary HCC at early stages. J. Clin. Lab. Anal. 23:213-218, 2009. (C) 2009 Wiley-Liss, Inc. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
AFP-IgM immune complexes, hepatocellular carcinoma, tumor marker, alpha-fetoprotein
in
Journal of Clinical Laboratory Analysis
volume
23
issue
4
pages
213 - 218
publisher
John Wiley & Sons
external identifiers
  • wos:000268748600005
  • scopus:68049101887
ISSN
1098-2825
DOI
10.1002/jcla.20321
language
English
LU publication?
yes
id
dc0fe993-3b1b-4b90-919b-904bbc51635c (old id 1478244)
date added to LUP
2009-09-23 10:00:37
date last changed
2017-11-05 03:30:08
@article{dc0fe993-3b1b-4b90-919b-904bbc51635c,
  abstract     = {We evaluated clinical significance of serum alpha-fetoprotein (AFP)-IgM immune complexes, in comparison with free AFP, on the diagnosis of primary hepatocellular carcinoma (HCC). Serum levels of AFP-IgM immune complexes and free AFP were determined by the ELISA method and electrochemiluminescence, respectively, in 103 healthy controls, 74 patients suffering from primary HCC, 27 patients suffering from liver cirrhosis, and 63 patients suffering from chronic hepatitis. The best cut-off value of AFP-IgM and free AFP for diagnosis of primary HCC were 300 AU/mL and 10 mu g/L respectively, according to the area under the curve (AUC) in this study. The sensitivity of AFP-IgM and free AFP were 64.9 and 79.7%, and the specificity were 75.6 and 80.3%, respectively, when all cases of primary HCC were analyzed, and the AUC of free AFP was larger than that of AFP-IgM (0.85 vs. 0.72, Z = 3.21). However, in case of primary HCC at early stages (stages I and II) were analyzed, the AUC of AFP-IgM was larger than that of free AFP (0.91 vs. 0.82, Z = 1.73), which demonstrated that the sensitivity of AFP-IgM and free AFP were 94.4 and 72.2%, and the specificity were 81.9 and 79.9%, respectively. When both AFP-IgM and free AFP were positive, the specificity of diagnosis of primary HCC was 89.1%, and the efficacy was 79.0%. It is concluded that either sensitivity or specificity of serum level of AFP-IgM immune complexes was higher than that of free AFP in the diagnosis of primary HCC at early stages. As there was false positive AFP-IgM existed in the patients suffering from cirrhosis and chronic hepatitis, the combination of free AFP and AFP-IgM could significantly increase specificity and decrease false negative and/or false positive in the primary HCC at early stages. J. Clin. Lab. Anal. 23:213-218, 2009. (C) 2009 Wiley-Liss, Inc.},
  author       = {Jiang, Jingting and Wu, Changping and Xu, Ning and Yibei, Zhu and Jun, Wu and Mei, Ji and Bin, Xu and Nilsson-Ehle, Peter and Zhang, Xueguan},
  issn         = {1098-2825},
  keyword      = {AFP-IgM immune complexes,hepatocellular carcinoma,tumor marker,alpha-fetoprotein},
  language     = {eng},
  number       = {4},
  pages        = {213--218},
  publisher    = {John Wiley & Sons},
  series       = {Journal of Clinical Laboratory Analysis},
  title        = {Clinical Evaluation of Serum Alpha-Fetoprotein-IgM Immune Complexes on the Diagnosis of Primary Hepatocellular Carcinoma},
  url          = {http://dx.doi.org/10.1002/jcla.20321},
  volume       = {23},
  year         = {2009},
}