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Title: Enhanced detection of early hepatocellular carcinoma by serum SELDI-TOF proteomic signature combined with alpha-fetoprotein marker
Authors: Chen, L.
Ho, D.W.Y.
Lee, N.P.Y.
Sun, S.
Lam, B.
Wong, K.-F. 
Yi, X.
Lau, G.K.
Ng, E.W.Y.
Poon, T.C.W.
Lai, P.B.S.
Cai, Z.
Peng, J.
Leng, X.
Poon, R.T.P.
Luk, J.M.
Issue Date: Sep-2010
Citation: Chen, L., Ho, D.W.Y., Lee, N.P.Y., Sun, S., Lam, B., Wong, K.-F., Yi, X., Lau, G.K., Ng, E.W.Y., Poon, T.C.W., Lai, P.B.S., Cai, Z., Peng, J., Leng, X., Poon, R.T.P., Luk, J.M. (2010-09). Enhanced detection of early hepatocellular carcinoma by serum SELDI-TOF proteomic signature combined with alpha-fetoprotein marker. Annals of Surgical Oncology 17 (9) : 2518-2525. ScholarBank@NUS Repository.
Abstract: Background: Biomarkers for accurate diagnosis of early hepatocellular carcinoma (HCC) are limited in number and clinical validation. We applied SELDI-TOF-MS ProteinChip technology to identify serum profile for distinguishing HCC and liver cirrhosis (LC) and to compare the accuracy of SELDI-TOF-MS profile and alpha-fetoprotein (AFP) level in HCC diagnosis. Patients and Methods: Serum samples were obtained from 120 HCC and 120 LC patients for biomarker discovery and validation studies. ProteinChip technology was employed for generating SELDI-TOF proteomic features and analyzing serum proteins/peptides. Results: A diagnostic model was established by CART algorithm, which is based on 5 proteomic peaks with m/z values at 3324, 3994, 4665, 4795, and 5152. In the training set, the CART algorithm could differentiate HCC from LC subjects with a sensitivity and specificity of 98% and 95%, respectively. The results were assessed in blind validation using separate cohorts of 60 HCC and 60 LC patients, with an accuracy of 83% for HCC and 92% for LC patients. The diagnostic odd ratio (DOR) indicated that SELDI-TOF proteomic signature could achieve better diagnostic performance than serum AFP level at a cutoff of 20 ng/mL (AFP20) (92.72 vs 9.11), particularly superior for early-stage HCC (87% vs 54%). Importantly, a combined use of both tests could enhance the detection of HCC (sensitivity, 95%; specificity, 98%; DOR, 931). Conclusion: Serum SELDI-TOF proteomic signature, alone or in combination with AFP marker, promises to be a good tool for early diagnosis and/screening of HCC in at-risk population with liver cirrhosis. © 2010 Society of Surgical Oncology.
Source Title: Annals of Surgical Oncology
ISSN: 10689265
DOI: 10.1245/s10434-010-1038-8
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