scholarly journals Diagnostic Performance of TE, 2D-SWE And MRE For Liver Fibrosis In Treatment-Naive People With HBV: A Systematic Review And Meta-Analysis

2021 ◽  
Author(s):  
Mingkai Li ◽  
Sizhe Wan ◽  
Xiaoying Wu ◽  
Bin Wu
Keyword(s):  
Diagnostic Accuracy ◽  
Linear Models ◽  
Transient Elastography ◽  
Meta Analysis ◽  
Previous Treatment ◽  
Shear Wave Elastography ◽  
Threshold Effect ◽  
Cochrane Library ◽  
Significant Fibrosis ◽  
Treatment Naïve

Abstract Background/aims: To assess the performance of transient elastography (TE), two-dimensional shear wave elastography (2D-SWE), and magnetic resonance elastography (MRE) for staging significant fibrosis and cirrhosis in untreated chronic hepatitis B (CHB) patients. Methods: Pubmed, Embase, Web of Science and Cochrane Library were searched for terms involving CHB, TE, SWE, and MRE. Other etiologies of chronic liver disease (CLD), previous treatment in patients or articles not published in SCI journals were excluded. Hierarchical non-linear models were used to evaluate the diagnostic accuracy of TE, 2D-SWE and MRE. Heterogeneity was explored via analysis of threshold effect and meta-regression. Results: Twenty-eight articles with a total of 4540 untreated CHB patients were included. The summary AUROC using TE, 2D-SWE and MRE for predicting significant fibrosis (SF) were 0.84, 0.89, and 0.99, respectively. MRE is more accurate than both TE (P＜0.01) and 2D-SWE (P＜0.01) in staging SF. 2D-SWE is superior to TE in detecting SF (P＜0.01). The summary AUROC employing TE, 2D-SWE and MRE for detecting cirrhosis were 0.9, 0.94, and 0.99, respectively. TE displayed a similar diagnostic accuracy with 2D-SWE in staging cirrhosis (P=0.14). MRE and 2D-SWE are comparable for staging cirrhosis (P=0.08). MRE is superior than TE (P＜0.01) in staging cirrhosis.Conclusion: TE, 2D-SWE, and MRE express acceptable diagnostic accuracies in staging staging significant fibrosis and cirrhosis in untreated CHB patients. Both MRE and 2D-SWE are better choices while the TE can be regarded as a secondary option.

scholarly journals Transient Elastography for Significant Liver Fibrosis and Cirrhosis in Chronic Hepatitis B: A Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-13 ◽  
Author(s):  
Xiaolong Qi ◽  
Min An ◽  
Tongwei Wu ◽  
Deke Jiang ◽  
Mengyun Peng ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Liver Fibrosis ◽  
Hepatitis B ◽  
Diagnostic Accuracy ◽  
Chronic Hepatitis B ◽  
Transient Elastography ◽  
Meta Analysis ◽  
Receiver Operating Curve ◽  
Significant Fibrosis ◽  
Receiver Operating

Background. The hepatitis B virus infection is a global health issue and the stage of liver fibrosis affects the prognosis in patients with chronic hepatitis B (CHB). We performed the meta-analysis describing diagnostic accuracy of transient elastography (TE) for predicting CHB-related fibrosis. Methods. We performed an adequate literature search to identify studies that assessed the diagnostic accuracy of TE in CHB patients using biopsy as reference standard. Hierarchical summary receiver-operating curves model and the bivariate mixed-effects binary regression model were applied to generate summary receiver-operating characteristic curves and pooled estimates of sensitivity and specificity. Results. The area under the summary receiver-operating curve for significant fibrosis and cirrhosis was 0.86 (95% confidence interval (CI): 0.83–0.89) and 0.92 (95% CI: 0.90–0.94), respectively. The sensitivity, specificity, and diagnostic odds ratio of TE for significant fibrosis were 0.78 (95% CI: 0.73–0.81, p<0.01; I2=85.59%), 0.81 (95% CI: 0.77–0.84, p<0.01; I2=88.20%), and 14.44 (95% CI: 10.80–19.31, p<0.01; I2=100%) and for cirrhosis were 0.84 (95% CI: 0.80–0.88, p<0.01; I2=76.67%), 0.87 (95% CI: 0.84–0.90, p<0.01; I2=90.89%), and 36.63 (95% CI: 25.38–52.87, p<0.01; I2=100%), respectively. The optimal cut-off values of TE were 7.25 kPa for diagnosing significant fibrosis and 12.4 kPa for diagnosing cirrhosis, respectively. Conclusion. TE is of great value in the detection of patients with CHB-related cirrhosis but has a suboptimal accuracy in the detection of significant fibrosis.

scholarly journals Shear wave elastography (SWE) may be more sensitive and more precise than transient elastography (TE) in predicting significant fibrosis in CHB patients：A prospective comparative study

2019 ◽  
Author(s):  
Tiantian Yao ◽  
Jing Pan ◽  
Jiandan Qian ◽  
Hao Cheng ◽  
Yan Wang ◽  
...  
Keyword(s):  
Liver Fibrosis ◽  
Liver Biopsy ◽  
Transient Elastography ◽  
Shear Wave Elastography ◽  
Altman Analysis ◽  
Optimal Cutoff ◽  
Bland Altman Analysis ◽  
Significant Fibrosis ◽  
Treatment Naïve ◽  
Spearman’S Correlation

Abstract Background Noninvasive measurements including transient elastography (TE) and the two-dimensional shear wave elastography (SWE) have been clinical used instead of liver biopsy for the regular assessment of liver fibrosis in patients during following-up. We aimed to investigate independent factors of SWE compared with TE and find the optimal cutoff values of these two non-invasive evaluation assessments based on our cohort of treatment-naive CHB patients. Methods Fifty-four treatment-naive CHB patients were enrolled and studied. All of them were performed SWE, TE, serum tests and liver biopsy. Potential factors of SWE and TE values were analysed by linear regression and orthogonal partial least squares (OPLS) discriminant analysis. The agreement, the association, the comparison of the two different methods were implemented based on the results of liver biopsy by using Bland–Altman analysis, spearman’s correlation and areas under the receive operating characteristic curves (AUROCs). Results There were 27 cases (50%) of mild fibrosis (F0-F2) and 27 (50%) cases of significant fibrosis (F3-F6), fibrosis was assessed with the Ishak scoring system. Multivariate linear regression analyses revealed that fibrosis stage was the only factor affecting the values of SWE (P<0.001), whereas total bilirubin levels (P=0.013) and fibrosis stage (P=0.037) were independent factors affecting TE values. OPLS showed the numbers independent factors (VIP>1) were more in TE than SWE. Bland-Altman analysis showed satisfied agreement between LSMs of SWE and TE. Both of SWE and TE could significantly evaluate significant fibrosis (P<0.001). Spearman’s correlation analysis revealed a correlation between liver fibrosis and LSMs of SWE and TE (r=0.65 and 0.50, P<0.001). Areas under receiver operating characteristics curves (AUROCs) of SWE and TE for significant fibrosis (F>2) were 0.786 and 0.714, respectively. The optimal cutoff values of LSMs of SWE and TE were 9.05kPa and 8.15kPa, respectively. Conclusions According to the AUROCs in comparative data, SWE may be more sensitive and more precise than TE in predicting significant fibrosis (>F2) in CHB patients. Compare to TE, the value of SWE is less affected by factors and will be more promising application prospects.

scholarly journals Comparing the Diagnostic Accuracy of RTE and SWE in Differentiating Malignant Thyroid Nodules from Benign Ones: a Meta-Analysis

2016 ◽  
Vol 39 (6) ◽  
pp. 2451-2463 ◽  
Author(s):  
Wuguo Tian ◽  
Shuai Hao ◽  
Bo Gao ◽  
Yan Jiang ◽  
Xiaohua Zhang ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Thyroid Nodules ◽  
Statistical Tests ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Shear Wave Elastography ◽  
Cochrane Library ◽  
Score System ◽  
Significant Difference ◽  
The Status

Background: Approximately 10-20 million Americans have been clinically diagnosed with thyroid nodules. Shear wave elastography (SWE) and real-time elastography (RTE) are two primary forms of elastography for identifying the status of thyroid nodules. The aim of this study is to assess the performance of RTE and SWE in identifying malignant thyroid nodules. Methods: Relevant articles were systematically retrieved from PubMed, Embase and Cochrane Library. In order to evaluate the overall diagnostic accuracy, we have considered pooled sensitivity (SEN), specificity (SPE), area under the curve (AUC) and partial AUC with corresponding 95% confidence intervals (95%CIs). Stratified analyses by ethnicity (Caucasian, Asian), the number of malignant nodules (> 50, < 50), score system (elasticity scores: ES and strain ration: SR) and ES (> 4, < 4) were performed to explore potential sources of heterogeneity. All statistical tests were performed using the R 3.2.1 software package. Results: We analyzed 80 trials from 71 studies with 16,624 subjects (12,348 for SWE, 4,276 for RTE). The pooled results suggested that RTE is more accurate than SWE in diagnosing malignant cases (RTE: SEN= 0.829, 95%CI = 0.799-0.855, SPE = 0.828, 95%CI = 0.789-0.862, AUC = 0.889; SWE: SEN = 0.784, 95%CI = 0.732-0.828, SPE = 0.824, 95%CI = 0.766-0.871, AUC = 0.859). No significant difference was found in the subgroup analyses. Conclusion: Our findings revealed that RTE is superior to SWE in differentiating malignant and benign thyroid nodules. Nevertheless, more studies focusing on the diagnostic accuracy of RTE and SWE during different stages of thyroid nodules development should be carried out in the future.

scholarly journals Salivary DNA Methylation as an Epigenetic Biomarker for Head and Neck Cancer. Part I: A Diagnostic Accuracy Meta-Analysis

2021 ◽  
Vol 11 (6) ◽  
pp. 568
Author(s):  
Óscar Rapado-González ◽  
Cristina Martínez-Reglero ◽  
Ángel Salgado-Barreira ◽  
Laura Muinelo-Romay ◽  
Juan Muinelo-Lorenzo ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Head And Neck Cancer ◽  
Diagnostic Accuracy ◽  
Head And Neck ◽  
Likelihood Ratio ◽  
Neck Cancer ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Epigenetic Mechanism ◽  
Cochrane Library

DNA hypermethylation is an important epigenetic mechanism for gene expression inactivation in head and neck cancer (HNC). Saliva has emerged as a novel liquid biopsy representing a potential source of biomarkers. We performed a comprehensive meta-analysis to evaluate the overall diagnostic accuracy of salivary DNA methylation for detecting HNC. PubMed EMBASE, Web of Science, LILACS, and the Cochrane Library were searched. Study quality was assessed by the Quality Assessment for Studies of Diagnostic Accuracy-2, and sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (dOR), and their corresponding 95% confidence intervals (CIs) were calculated using a bivariate random-effect meta-analysis model. Meta-regression and subgroup analyses were performed to assess heterogeneity. Eighty-four study units from 18 articles with 8368 subjects were included. The pooled sensitivity and specificity of salivary DNA methylation were 0.39 and 0.87, respectively, while PLR and NLR were 3.68 and 0.63, respectively. The overall area under the curve (AUC) was 0.81 and the dOR was 8.34. The combination of methylated genes showed higher diagnostic accuracy (AUC, 0.92 and dOR, 36.97) than individual gene analysis (AUC, 0.77 and dOR, 6.02). These findings provide evidence regarding the potential clinical application of salivary DNA methylation for HNC diagnosis.

scholarly journals Comparative diagnostic accuracy of EUS needles in solid pancreatic masses: a network meta-analysis

2021 ◽  
Vol 09 (06) ◽  
pp. E853-E862
Author(s):  
Samuel Han ◽  
Furqan Bhullar ◽  
Omar Alaber ◽  
Ayesha Kamal ◽  
Puanani Hopson ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Sampling Technique ◽  
Standard Of Care ◽  
Needle Aspiration ◽  
Cochrane Library ◽  
Pancreatic Masses ◽  
Quantitative Synthesis ◽  
Made In

Abstract Background and study aims Endoscopic ultrasound (EUS)-guided tissue sampling is the standard of care for diagnosing solid pancreatic lesions. While many two-way comparisons between needle types have been made in randomized controlled trials (RCTs), it is unclear which size and type of needle offers the best probability of diagnosis. We therefore performed a network meta-analysis (NMA) to compare different sized and shaped needles to rank the diagnostic performance of each needle. Methods We searched MEDLINE, EMBASE and Cochrane Library databases through August, 2020 for RCTs that compared the diagnostic accuracy of EUS fine-needle aspiration (FNA) and biopsy (FNB) needles in solid pancreatic masses. Using a random-effects NMA under the frequentist framework, RCTs were analyzed to identify the best needle type and sampling technique. Performance scores (P-scores) were used to rank the different needles based on pooled diagnostic accuracy. The NMA model was used to calculate pairwise relative risk (RR) with 95 % confidence intervals. Results Review of 2577 studies yielded 29 RCTs for quantitative synthesis, comparing 13 different needle types. All 22G FNB needles had an RR > 1 compared to the reference 22G FNA (Cook) needle. The highest P-scores were seen with the 22G Medtronic FNB needle (0.9279), followed by the 22G Olympus FNB needle (0.8962) and the 22G Boston Scientific FNB needle (0.8739). Diagnostic accuracy was not significantly different between needles with or without suction. Conclusions In comparison to FNA needles, FNB needles offer the highest diagnostic performance in sampling pancreatic masses, particularly with 22G FNB needles.

Association of previous treatment with anti-tumour necrosis factor inhibitors with the effectiveness of secukinumab in the treatment of psoriatic arthritis: systematic review and meta-analysis

Rheumatology ◽  
2020 ◽  
Vol 59 (12) ◽  
pp. 3657-3665
Author(s):  
Yantao Xu ◽  
Yuting Li ◽  
Mengyuan Dong ◽  
Zi’ang Gao ◽  
Xiang Chen ◽  
...  
Keyword(s):  
Psoriatic Arthritis ◽  
Meta Analysis ◽  
Previous Treatment ◽  
Cochrane Library ◽  
Acr20 Response ◽  
Naive Group ◽  
American College Of Rheumatology ◽  
History Of ◽  
Effectiveness Data ◽  
Necrosis Factor

Abstract Objectives We sought to systematically investigate the effectiveness of secukinumab in psoriatic arthritis (PsA) patients who previously received TNFs inhibitor (TNFi) treatment and those who were TNFi naïve. Methods Databases (PubMed, EMBase and Cochrane library) and ClinicalTrials.gov were searched from inception to 22 May 2020 for randomized control trails and observational studies of secukinumab, with or without a history of previous anti-TNFi treatment, in PsA. Effectiveness data were extracted and combined using a random-effects meta-analysis. The ACR20 and ACR50 (20% and 50% improvement in American College of Rheumatology response criteria) responses were the endpoints. Results Six randomized controlled trials that reported the effectiveness of secukinumab by previous anti-TNFi treatment were included. Among patients exposed to a prior anti-TNFi treatment (n = 738), 33.7% (249/738) of patients achieved an ACR20 response. In contrast, in the anti-TNFi-naïve group (n = 1754), 49.8% (873/1754) of patients achieved an ACR20 response. Prior treatment with anti-TNFi was significantly associated with a poorer response to secukinumab compared with the anti-TNFi-naïve group with an effect size of 2.09 (95% CI: 1.69, 2.58). Conclusion Some patients benefit from switching from TNFi to secukinumab, but previous anti-TNFi treatment is associated with poorer effectiveness of secukinumab.

scholarly journals Diagnostic accuracy of transthoracic echocardiography for pulmonary hypertension: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033084 ◽  
Author(s):  
Jin-Rong Ni ◽  
Pei-Jing Yan ◽  
Shi-Dong Liu ◽  
Yuan Hu ◽  
Ke-Hu Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pulmonary Hypertension ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Transthoracic Echocardiography ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Cochrane Library ◽  
Lower Sensitivity ◽  
Time Interval

ObjectiveTo evaluate the diagnostic accuracy of transthoracic echocardiography (TTE) in patients with pulmonary hypertension (PH).DesignSystematic review and meta-analysis.Data sources and eligibility criteriaEmbase, Cochrane Library for clinical trials, PubMed and Web of Science were used to search studies from inception to 19 June, 2019. Studies using both TTE and right heart catheterisation (RHC) to diagnose PH were included.Main resultsA total of 27 studies involving 4386 subjects were considered as eligible for analysis. TTE had a pooled sensitivity of 85%, a pooled specificity of 74%, a pooled positive likelihood ratio of 3.2, a pooled negative likelihood ratio of 0.20, a pooled diagnostic OR of 16 and finally an area under the summary receiver operating characteristic curve of 0.88. The subgroup with the shortest time interval between TTE and RHC had the best diagnostic effect, with sensitivity, specificity and area under the curve (AUC) of 88%, 90% and 0.94, respectively. TTE had lower sensitivity (81%), specificity (61%) and AUC (0.73) in the subgroup of patients with definite lung diseases. Subgroup analysis also showed that different thresholds of TTE resulted in a different diagnostic performance in the diagnosis of PH.ConclusionTTE has a clinical value in diagnosing PH, although it cannot yet replace RHC considered as the gold standard. The accuracy of TTE may be improved by shortening the time interval between TTE and RHC and by developing an appropriate threshold. TTE may not be suitable to assess pulmonary arterial pressure in patients with pulmonary diseases.PROSPERO registration numberPROSPERO CRD42019123289.

Reliability of Transient Elastography-Based Liver Stiffness for Diagnosing Portal Hypertension in Patients with Alcoholic Liver Disease: A Diagnostic Meta-Analysis with Specific Cut-Off Values

2019 ◽  
Vol 41 (01) ◽  
pp. 60-68 ◽  
Author(s):  
Jinzhen Song ◽  
Zida Ma ◽  
Jianbo Huang ◽  
Yan Luo ◽  
Romanas Zykus ◽  
...  
Keyword(s):  
Portal Hypertension ◽  
Liver Disease ◽  
Sensitivity And Specificity ◽  
Alcoholic Liver Disease ◽  
Transient Elastography ◽  
Meta Analysis ◽  
Liver Stiffness ◽  
Cochrane Library ◽  
Bivariate Model ◽  
Disease Etiology

Abstract Background Transient elastography-based liver stiffness value (TE-LSV) has been studied for the diagnosis of portal hypertension. Liver stiffness is influenced by the disease etiology. We aimed to perform a meta-analysis to determine the performance of TE-LSV for diagnosing portal hypertension in patients with alcoholic liver disease (ALD). Methods We searched PubMed, Web of Science, Ovid and Cochrane library. A bivariate model was used to compute sensitivity and specificity. A random effects model was used to pool diagnostic odds ratios. Results 9 studies with 679 patients were included. The pooled sensitivity and specificity based on a cut-off value around 21.8 kPa for clinically significant portal hypertension (CSPH) were 0.89 (95 % confidence interval (CI), 0.83–0.93) and 0.71(95 % CI, 0.64–0.78), respectively. For severe portal hypertension (SPH), the pooled sensitivity and specificity for a cut-off value around 29.1 kPa were 0.88 (95 % CI, 0.83–0.92) and 0.74 (95 % CI, 0.67–0.81), respectively. Conclusion TE-LSV showed good performance for diagnosing portal hypertension in patients with ALD. The optimal cut-off value for CSPH and SPH was around 21.8 kPa and 29.1 kPa, respectively, and these two cut-off values showed good sensitivity and modest specificity. The etiology should be clear before using TE-LSV for portal hypertension.

scholarly journals Accuracy of multiparametric magnetic resonance imaging for detecting extracapsular extension in prostate cancer: a systematic review and meta-analysis

2019 ◽  
Vol 92 (1104) ◽  
pp. 20190480 ◽  
Author(s):  
Fan Zhang ◽  
Chen-Lu Liu ◽  
Qian Chen ◽  
Sheng-Chao Shao ◽  
Shuang-Qing Chen
Keyword(s):  
Prostate Cancer ◽  
Confidence Interval ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
High Specificity ◽  
Cochrane Library ◽  
Extracapsular Extension ◽  
Predictive Values ◽  
Enhanced Mri

Objective: To evaluate the diagnostic accuracy of multiparametric MRI (mpMRI) for detecting extracapsular extension (ECE) in patients with prostate cancer (PCa). Methods and materials: We searched MEDLINE, PubMed, Embase and the Cochrane library up to December 2018. We included studies that used mpMRI to differentiate ECE from organ-confined PCa with a combination of T2 weighted imaging (T2WI), diffusion-weighted imaging, and dynamic contrast-enhanced MRI. All studies included had pathological diagnosis with radical prostatectomy. Two reviewers independently assessed the methodological quality of included studies by using Quality Assessment of Diagnostic Accuracy Studies 2 tool. We calculated pooled sensitivity, specificity, positive and negative predictive values, diagnostic odds ratios and receiver operating characteristic curve for mpMRI from 2 × 2 tables. Results: A total of 17 studies that comprised 3374 participants were included. The pooled data showed a sensitivity of 0.55 (95% confidence interval 0.43, 0.66]) and specificity of 0.87 (95% confidence interval 0.82, 0.91) for extracapsular extension detection in PCa. Conclusion: First, our meta-analysis shows moderate sensitivity and high specificity for mpMRI to differentiate ECE from organ-confined prostate cancer before surgery. Second, our meta-analysis shows that mpMRI had no significant differences in performance compared with the former meta-analysis with use of T2WI alone or with additional functional MRI. Advances in knowledge: It is the first meta-analysis to evaluate the accuracy of mpMRI in combination of TWI, diffusion-weightedimaging and dynamiccontrast-enhanced-MRI for extracapsular extension detection.

Performance of Serum Glypican 3 in Diagnosis of Hepatocellular Carcinoma: A meta-analysis

2018 ◽  
Vol 17 (5) ◽  
pp. 0-10
Author(s):  
Dahai Xu ◽  
Chang Su ◽  
Liang Sun ◽  
Yuanyuan Gao ◽  
Youjun Li
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Operating Characteristic ◽  
Web Of Science ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Positive Control ◽  
Cochrane Library ◽  
Non Invasive

Introduction and aim. Serum glypican-3 (GPC3) has been explored as a non-invasive biomarker of hepatocellular carcinoma (HCC). However, controversy remains on its diagnostic accuracy. Therefore, we aimed to conduct a systematic review and metaanalysis to evaluate the differential diagnostic accuracy of serum GPC3 between HCC and liver cirrhosis (LC) cases. Material and methods. After the strict filtering and screening of studies from NCBI, PUBMED, Clinical Trials, Cochrane library, Embase, Prospero and Web of Science databases, 11 studies were selected. All studies provided the sensitivity and specificity of GPC3 and the alpha-fetoprotein (AFP) in the HCC and LC diagnosis. The sensitivity and specificity, and the area under the receiver operating characteristic curve (AUC) were determined and compared between GPC3 and AFP, which was set as a positive control. Results. Pooled sensitivity (95% CI) and specificity (95% CI) were 0.55 (0.52-0.58) and 0.58 (0.54-0.61) for GPC3, 0.54 (0.51-0.57) and 0.83 (0.80-0.85) for AFP, and 0.85 (0.81-0.89) and 0.79 (0.73-0.84) for GPC3 + AFP, respectively. The AUCs of GPC3, AFP and GPC3 + AFP were 0.7793, 0.7867 and 0.9366, respectively. GPC3 had a nearly similar sensitivity as AFP, while the specificity and AUC of GPC3 was lower than that of AFP. The combination of GPC3 and AFP yielded a better sensitivity and AUC than GPC3 or AFP. Conclusion. Serum GPC3 is inferior to AFP in the differential diagnosis between HCC and LC. However, the combination of GPC3 and AFP exhibited a much better performance.

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