Among 1,031 patients randomized in the Hepatitis C Antiviral Long-Term Treatment Against Cirrhosis Trial, a nested case-control study of 39 HCC cases (24 early stage) and 77 matched controls was conducted to compare the performance of AFP and DCP. Testing was performed on serial serum samples collected during a 12 month period prior to the time of HCC diagnosis.

DCP was not superior to AFP in the early detection of HCC in patients with advanced hepatitis C and neither AFP alone, DCP alone, nor the combination of AFP and DCP was sufficiently accurate to be used for HCC surveillance. The combination of both markers enhanced the sensitivity, indicating that these two markers are complementary. Therefore, prospective studies should be conducted to determine if combining both markers will improve the detection of early HCC and to establish the optimal cutoff values that should be used for patient recall and further testing.

"Until better serum markers are available, ultrasonography remains the preferred tool for HCC surveillance. However, reliable biomarkers to complement ultrasound may improve the detection of early HCC in clinical practice where interpretation of ultrasound is variable," says Lok. In this study, diagnosis of early HCC was triggered by surveillance ultrasound in only 58 percent of patients.

SOURCE American Gastroenterological Association