A comparison of glypican-3 with alpha-fetoprotein as a serum marker for hepatocellular carcinoma: a meta-analysis

Glypican-3(GPC3) has been reported as one of the most promising serum markers for hepatocellular carcinoma (HCC), while several studies have conflicting results for the diagnostic accuracy between GPC3 and alpha-fetoprotein (AFP). Studies that explored the diagnostic value of GPC3 and AFP in HCC were searched in MEDLINE, EMBASE, PUBMED, the Cochrane Library and Chinese biomedical literature database (CBM). Sensitivity, specificity and other measures about the accuracy of serum GPC3 and AFP in the diagnosis of HCC were pooled using random effects models. Summary receiver operating characteristic curve (sROC) analysis was used to summarize the overall test performance. Ten studies were included in our meta-analysis. The pooled sensitivity for AFP and GPC3 is 51.9 % (95 % confidence interval (CI) 0.47-0.56) and 59.2 % (95 % CI 0.55-0.63), respectively, while the pooled specificity for AFP and GPC3 is 94 % (95 % CI 92.1-95.6 %) and 84.8 % (95 % CI 82-87.3 %), respectively. The pooled diagnostic odds ratio (DOR) for AFP and GPC3 were 23.4 (95 % CI 10.3-53.2) and 17.99 (95 % CI 5.4-60.4), respectively. Area under sROC for both AFP and GPC3 is 0.81 (95 % CI 0.77-0.84). GPC3 is comparable to AFP as a serum marker for the diagnosis of HCC, combination of AFP and GPC3 can elevate the sensitivity of diagnosis.