Diagnostic value of des-gamma carboxy prothrombin as compared with alpha feto-protein in hepatocellular carcinoma among Filipinos: A preliminary report.

INTRODUCTION: Des-gamma carboxy prothrombin (DCP) has been cited in several studies to be an important diagnostic tool in hepatocellular carcinoma (HCC), which is the fourth leading cancer in both sexes combined (7.1 percent). The median survival of HCC is only 3.13 months after the onset of symptoms, and periodic screening among the high-risk population would benefit in detecting HCC at an early curable stage.

OBJECTIVES: To evaluate the sensitivity and specificity of DCP as compared with alpha feto-protein (AFP) in detecting HCC.

METHODS: This is a cross-sectional validation study on patients presenting with a liver mass at St. Luke's Medical Center from January 2006. The diagnosis of HCC was made by liver biopsy with imaging such as enhanced CT scan and/or magnetic resonance imaging.

RESULTS: This preliminary report was conducted on 15 patients who met the inclusion and exclusion criteria. There were eight patients diagnosed to have HCC, six patients had metastatic disease and one with a pyogenic liver abscess presenting as a mass. The mean serum concentrations of DCP were higher in the patients with HCC compared to the patients with metastatic disease or non-HCC (NHCC). The sensitivity of DCP was 100 percent (8/8) while that of AFP was 62 percent (5/8). The specificity of DCP was also at 86 percent (6/7) as compared with 71 percent (5/7) for AFP.

CONCLUSION: In this preliminary report, the study indicates that DCP is comparable to AFP as a diagnostic tool in detecting HCC.