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Urinary transforming growth factor α and serum α-fetoprotein as tumor markers of hepatocellular carcinoma

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Tumor Biology

Abstract

This case–control study aimed to evaluate the diagnostic application of urinary transforming growth factor (TGF) α and serum α-fetoprotein (AFP) in hepatocellular carcinoma (HCC). TGFα and AFP were determined in 90 pairs of age- and gender-matched patients with cirrhotic HCC and patients with cirrhosis alone and 60 healthy controls. The results indicated that TGFα and AFP levels in patients with HCC were higher than in those with cirrhosis alone or healthy controls (each P = 0.0001). Multivariate analysis indicated that TGFα (odds ratio (OR) 1.03, 95 % confidence interval (CI) 1.05–1.16) and AFP (OR 1.03, 95 % CI 1.01–1.06) were closely associated, in a dose-related fashion, with the development of HCC. The optimal cutoff values, determined with the receiver operating characteristic (ROC) curves, were 29 μg/g creatinine for TGFα and 100 ng/ml for AFP, respectively. The areas under ROC curve (AUC) were 0.74 for TGFα and 0.78 for AFP, respectively. Both biomarkers showed the same sensitivity (52.2 %), high specificity, high positive predictive value, and moderate positive likelihood ratio. Determination of both markers in parallel significantly increased the AUC (0.91) and diagnostic accuracy (92.2 %), with a high sensitivity (86.7 %), specificity (97.8 %), positive predictive value (PPV; 97.5 %), and moderate positive likelihood ratio (PLR; 39.4). Among 31 cirrhotic HCC with AFP ≤ 20 ng/ml, the calculated AUC for TGFα was 0.79, with a sensitivity of 64.5 %, specificity of 96.7 %, PPV of 87.0 %, and PLR of 19.5. In conclusion, urinary TGFα and serum AFP are complementary tumor markers for detection of HCC with low AFP production.

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Acknowledgments

This work was supported in part by grants from the National Science Council of the Republic of China (NSC 93-2314-B-037-079) and the Kaohsiung Medical University Hospital (KMUH 97-7R26).

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Authors and Affiliations

  1. Department of Laboratory Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan

    Jen-Eing Jeng

  2. Department of Pediatrics, MacKay Memorial Hospital, Taipei, 10449, Taiwan

    Meng-Feng Tsai

  3. Department of Internal Medicine, Madow Sin-Lau Hospital, Tainan, Taiwan

    Hey-Ru Tsai

  4. Department of Biochemistry, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan

    Lea-Yea Chuang

  5. Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, 80708, Taiwan

    Zu-Yau Lin, Min-Yuh Hsieh, Shinn-Chern Chen, Wan-Lung Chuang, Liang-Yen Wang, Min-Lung Yu, Chia-Yen Dai & Jung-Fa Tsai

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  1. Jen-Eing Jeng
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Correspondence to Lea-Yea Chuang or Jung-Fa Tsai.

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J.-E. Jeng, H.-R. Tsai, and M.-F. Tsai contributed equally to this work.

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Jeng, JE., Tsai, MF., Tsai, HR. et al. Urinary transforming growth factor α and serum α-fetoprotein as tumor markers of hepatocellular carcinoma. Tumor Biol. 35, 3689–3698 (2014). https://doi.org/10.1007/s13277-013-1488-2

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  • DOI: https://doi.org/10.1007/s13277-013-1488-2

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