Clinical utility of decarboxylation prothrombin combined with α-fetoprotein for diagnosing primary hepatocellular carcinoma

We conducted a comprehensive analysis to evaluate clinical utility of decarboxylation prothrombin combined with alpha-fetoprotein for diagnosing primary hepatocellular carcinoma (HCC). Systematical searches were performed in PubMed, Web of Sciences, China National Knowledge Internet, and Wangfang databases. The bivariate random-effect model was used to calculate the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood, diagnostic odds ratio, and summary area under the curve. Fourteen studies were included in the meta-analysis. For decarboxylation prothrombin, the overall pooled parameters as follows: sensitivity: 79% (95% confidence interval (CI): 74%-84%), specificity: 91% (95%CI: 87%-93%), positive likelihood ratio: 8.42 (95%CI: 5.79-12.23), negative likelihood ratio: 0.23 (95%CI: 0.17-0.30), diagnostic odds ratio: 37.09 (95%CI: 21.37-64.36), summary area under the curve: 0.92 (95%CI: 0.89-0.94); For combined diagnostic, the overall pooled parameters as follows: sensitivity: 91% (95%CI: 85%-95%), specificity: 83% (95%CI: 74%-89%), positive likelihood ratio: 5.26 (95%CI: 3.53-7.83), negative likelihood ratio: 0.11 (95%CI: 0.07-0.18), diagnostic odds ratio: 47.14 (95%CI: 30.09-73.85), summary area under the curve: 0.94 (95%CI: 0.91-0.95). The serum decarboxylation prothrombin shown a relatively higher diagnostic specificity for primary hepatocellular cancer, and decarboxylation prothrombin combined with alpha-fetoprotein exhibited can improve sensitivity for HCC than any of the biomarkers alone.