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Nouso et al. Hepatoma Res 2018;4:73 Hepatoma Research
DOI: 10.20517/2394-5079.2018.93

Original Article Open Access

Simple screening method for the diagnosis of nonB-
nonC hepatocellular carcinoma

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Kazuhiro Nouso , Yoshie Furubayashi , Shohei Shiota , Akiko Wakuta , Ayano Oonishi , Kazuya
Kariyama , Yasuto Takeuchi , Nozomu Wada , Hideki Onishi , Takuya Adachi , Atsushi Oyama , Chihiro
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Dohi , Tetsuya Yasunaka , Yuki Yasunaka , Fusao Ikeda , Hidenori Shiraha , Akinobu Takaki , Hiroyuki
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Okada 2
1 Department of Gastroenterology, Okayama City Hospital, Okayama 700-8557, Japan.
2 Department of Gastroenterology and Hepatology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical
Sciences, Okayama 700-8558, Japan.
Correspondence to: Dr. Kazuhiro Nouso, Department of Gastroenterology, Okayama City Hospital, 3-20-1, Kitanagase-omotemachi,
Kita-ku, Okayama City, Okayama 700-8557, Japan. E-mail: kazunouso@gmail.com
How to cite this article: Nouso K, Furubayashi Y, Shiota S, Wakuta A, Oonishi A, Kariyama K, Takeuchi Y, Wada N, Onishi H, Adachi T,
Oyama A, Dohi C, Yasunaka T, Yasunaka Y, Ikeda F, Shiraha H, Takaki A, Okada H. Simple screening method for the diagnosis of nonB-
nonC hepatocellular carcinoma. Hepatoma Res 2018;4:73. http://dx.doi.org/10.20517/2394-5079.2018.93
Received: 8 Aug 2018 First Decision: 31 Aug 2018 Revised: 8 Nov 2018 Accepted: 9 Nov 2018 Published: 12 Dec 2018
Science Editor: Guang-Wen Cao Copy Editor: Cui Yu Production Editor: Huang-Liang Wu
Abstract
Aim: The incidence of non-virus-related nonB-nonC hepatocellular carcinoma (NBNC-HCC) is on the rise.
However, screening at-risk individuals using imaging methods is complicated by the large size of the at-risk patient
pool. The aim of this study is to develop an effective simple screening method, using blood tests.
Methods: The diagnostic value of aspartate aminotransferase (AST), alpha-fetoprotein (AFP), and des-gamma-
carboxy prothrombin (DCP) was analyzed using sera from 203 NBNB-HCC patients and 106 diabetes mellitus
patients.

Results: Areas under receiver operating characteristic curves for AST, AFP, and DCP were 0.844, 0.901, and
0.914, respectively. The optimal cut-offs for diagnosing NBNC-HCC based on Youden indices were 30 IU/L,
3.6 ng/mL, and 25 mAU/mL, respectively. On selecting patients who were positive at least one parameter (AST,
AFP, or DCP), the sensitivity was 97.5%. This high sensitivity was preserved (98.0%) even in cases of non-
advanced HCC (≤ 3 cm, ≤ 3 nodules). Specificity was 72.6%.

Conclusion: This simple triple screen for AST, AFP, and DCP appears to have diagnostic value in NBNC-HCC and
could be used to select candidates for further testing using imaging.

Keywords: Hepatocellular carcinoma, screening, diagnosis, alpha-fetoprotein, aspartate aminotransferase,
desgamma-carboxy-prothrombin
© The Author(s) 2018. Open Access This article is licensed under a Creative Commons Attribution 4.0
International License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use,
sharing, adaptation, distribution and reproduction in any medium or format, for any purpose, even commercially, as long
as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license,
and indicate if changes were made.

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