The role of α-fetoprotein (AFP) in the surveillance and diagnosis of hepatocellular carcinoma (HCC) has been questioned in recent years due to its low sensitivity and specificity. In addition to AFP, several new serum biomarkers, such as lens culinaris agglutinin-reactive fraction of AFP (AFP-L3) and des-gamma-carboxy prothrombin (DCP), have also been identified as useful HCC serological markers. However, the exact diagnostic value of the combinations of these biomarkers for detecting HCC in patients with liver disease remains unclear. Thus, we performed the current meta-analysis to assess performance of AFP+AFP-L3%+DCP for diagnosing HCC. Studies were systematically searched in PubMed, Embase, the Cochrane Library, CNKI, and WanFang Data databases. After full-text evaluation, 13 studies from 11 articles focusing on the combination of the three serum biomarkers for HCC detection were enrolled. Random-effects models were used due to the presence of heterogeneity. The pooled sensitivity and specificity for AFP+AFP-L3%+DCP were 88% and 79%, respectively. The area under the summary receiver operating characteristic (sROC) curve was 0.91, and the diagnostic odds ratio (DOR) was 28.33 (95% CI 16.78-47.83). Subgroup analysis showed that the pooled sensitivity and specificity of AFP+AFP-L3%+DCP in the diagnosis of HCC versus cirrhosis patients were 0.81 and 0.82, respectively. In conclusion, the combination of AFP, AFP-L3%, and DCP may prove to be useful in the diagnosis and screening of HCC.

中文翻译：

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AFP，AFP-L3％和DCP联合应用在肝细胞癌诊断中的评价：荟萃分析

α的作用甲胎蛋白（AFP）在肝细胞癌（HCC）的监视和诊断中由于其低敏感性和特异性而受到质疑。除AFP以外，几种新的血清生物标志物，例如AFP的晶状体凝集素反应性部分（AFP-L3）和去γ-羧基凝血酶原（DCP）也已被鉴定为有用的HCC血清学标志物。但是，这些生物标记物组合对肝病患者检测HCC的确切诊断价值仍不清楚。因此，我们进行了当前的荟萃分析，以评估AFP + AFP-L3％+ DCP诊断HCC的性能。在PubMed，Embase，Cochrane图书馆，CNKI和WanFang Data数据库中系统地搜索了研究。经过全文评估，从11篇文章中进行了13项研究，重点研究了用于HCC检测的三种血清生物标志物的组合。由于存在异质性，因此使用了随机效应模型。AFP + AFP-L3％+ DCP的合并敏感性和特异性分别为88％和79％。摘要接收器工作特性（sROC）曲线下的面积为0.91，诊断比值比（DOR）为28.33（95％CI 16.78-47.83）。亚组分析显示，AFP + AFP-L3％+ DCP在肝癌和肝硬化患者中的综合敏感性和特异性分别为0.81和0.82。总之，AFP，AFP-L3％和DCP的组合可能被证明可用于肝癌的诊断和筛查。AFP + AFP-L3％+ DCP的合并敏感性和特异性分别为88％和79％。摘要接收器工作特性（sROC）曲线下的面积为0.91，诊断比值比（DOR）为28.33（95％CI 16.78-47.83）。亚组分析显示，AFP + AFP-L3％+ DCP在肝癌和肝硬化患者中的综合敏感性和特异性分别为0.81和0.82。总之，AFP，AFP-L3％和DCP的组合可能被证明可用于肝癌的诊断和筛查。AFP + AFP-L3％+ DCP的合并敏感性和特异性分别为88％和79％。摘要接收器工作特性（sROC）曲线下的面积为0.91，诊断比值比（DOR）为28.33（95％CI 16.78-47.83）。亚组分析显示，AFP + AFP-L3％+ DCP在肝癌和肝硬化患者中的综合敏感性和特异性分别为0.81和0.82。总之，AFP，AFP-L3％和DCP的组合可能被证明可用于肝癌的诊断和筛查。亚组分析显示，AFP + AFP-L3％+ DCP在肝癌和肝硬化患者中的综合敏感性和特异性分别为0.81和0.82。总之，AFP，AFP-L3％和DCP的组合可能被证明可用于肝癌的诊断和筛查。亚组分析显示，AFP + AFP-L3％+ DCP在肝癌和肝硬化患者中的综合敏感性和特异性分别为0.81和0.82。总之，AFP，AFP-L3％和DCP的组合可能被证明可用于肝癌的诊断和筛查。