ArticleJournal of clinical medicine2022
Diagnostic Performance of AFP, AFP-L3, or PIVKA-II for Hepatitis C Virus-Associated Hepatocellular Carcinoma: A Multicenter Analysis.
Article in Journal of clinical medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05626985 (Refinement and Validation of a Comprehensive Clinical Diagnostic Model), which is not on this map. Cited by 25 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Refinement and Validation of a Comprehensive Clinical Diagnostic Model (GAMAD) for Early Detection of Hepatocellular Carcinoma: A Multicenter, Prospective Study Protocol
Who cites it
25 citing papers in PubMed, 37 citations in OpenAlex.
- Molecular biomarkers for diagnosis, prognosis, precision therapy, and immunotherapy in cholangiocarcinoma, cHCC-CCA, and HCC.Hepatology communications · 2026Review
- Development and validation of a high-confidence diagnostic model integrating ctDNA methylation and serum biomarkers for early-stage hepatocellular carcinoma detection.Molecular biomedicine · 2026Article
- Comparison of diagnostic performance of GAAD, GALAD, and ASAP scores for detecting hepatocellular carcinoma in advanced liver fibrosis patients.Advances in laboratory medicine · 2026Article
- The mechanism of action, clinical significance, and research progress of tumor antigen-specific T cells in the treatment of HCC.Frontiers in oncology · 2026Review
- Effect of AFP and PIVKA-II secretion status on prognosis of advanced hepatocellular carcinoma patients receiving TACE combined with systemic therapy.BMC cancer · 2025Article
- Article
- Evaluating the combined diagnostic power of alpha-fetoprotein and protein induced by vitamin K absence or antagonist-II for hepatocellular carcinoma.Journal of gastrointestinal oncology · 2025Article
- A stratified precision screening strategy for enhancing hepatitis B- and C-associated liver cancer detection: a prospective study.Scientific reports · 2025Article
- Article
- Comparative evaluation of multimarker algorithms for early-stage HCC detection in multicenter prospective studies.JHEP reports : innovation in hepatology · 2025Article
- Article
- Early PIVKA-II Response Predicts Treatment Efficacy of Immune Checkpoint Inhibitors in Patients with Advanced Hepatocellular Carcinoma.Journal of hepatocellular carcinoma · 2025Article
- The Diagnostic Performance of AFP, AFP-L3, DCP, CA199, and Their Combination for Primary Liver Cancer.Journal of hepatocellular carcinoma · 2025Article
- Serum tumor marker and CT body composition scoring system predicts outcomes in colorectal cancer surgical patients.European radiology · 2024Article
- Surveillance Imaging and GAAD/GALAD Scores for Detection of Hepatocellular Carcinoma in Patients with Chronic Hepatitis.Journal of clinical and translational hepatology · 2024Article
- Prospective appraisal of clinical diagnostic algorithms for hepatocellular carcinoma surveillance in Chinese patients with chronic hepatitis B infection.Scientific reports · 2024Article
- Biomarkers for diagnosis and therapeutic options in hepatocellular carcinoma.Molecular cancer · 2024Review
- YAP-based nomogram predicts poor prognosis in patients with hepatocellular carcinoma after curative surgery.Journal of gastrointestinal oncology · 2024Article
- Des-gamma-carboxy prothrombin and alpha-fetoprotein levels as biomarkers for hepatocellular carcinoma and their correlation with radiological characteristics.World journal of gastrointestinal pathophysiology · 2024Article
- Article
Corrections and comments
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Authors and funding
14 authors at 6 institutions in 3 countries.
Funding
Abstract
Background and Aim: Alpha-fetoprotein (AFP), a lens culinaris agglutinin-reactive fraction of AFP (AFP-L3), is a protein that is induced by vitamin K deficiency or antagonist-II (PIVKA-II) that has been clinically used as a serum biomarker for early detection and diagnosis of hepatocellular carcinoma (HCC). Diagnostic performance of each serum biomarker alone, or their combinations for the detection of hepatitis C virus (HCV)-associated HCC were compared. Methods: Serum AFP, AFP-L3, and PIVKA-II levels were evaluated in patients with HCV-associated HCC, and those with chronic HCV infection without HCC (HCV-controls). The areas under the curve (AUC), sensitivity, and specificity were compared to identify the diagnostic performance of each serum HCC biomarker alone or in combination. Results: Overall, 172 HCV controls and 105 patients with HCV-associated HCC were enrolled. The AFP, AFP-L3, and PIVKA-II levels were significantly increased among patients with HCV-associated HCC when compared with HCV patients without HCC (p < 0.001). When these biomarkers were analyzed individually, PIVKA-II revealed the best predictive performance (AUC: PIVKA-II 0.90 vs. AFP 0.80 vs. AFP-L3 0.69, p < 0.001). In evaluating the combinations of any two biomarkers, the best predictive performance was found in PIVKA-II + AFP (0.93 vs. AFP + AFP-L3 0.78, p = 0.001; and PIVKA-II + AFP-L3 0.89, p < 0.001), which had no difference compared to the predictive performance of the combination of all three serum biomarkers (AFP + AFP-L3 + PIVKA-II 0.93, p = 0.277). Similar results were identified in the subgroups of patients with HCV-induced cirrhosis, and among patients with early-stage HCC defined by BCLC and TNM staging. Conclusions: The addition of the PIVKA-II test to routine AFP test maybe provide a more suitable biomarker approach to detect HCV-induced HCC in patients with HCV infection undergoing HCC surveillance.
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