Affiliations: [a] Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan | [b] Center for Infectious Diseases, Kobe University Graduate School of Medicine, Kobe, Japan | [c] Division of Psychiatry and Neurology, Department of Environmental Health and Safety, Kobe University Graduate School of Medicine, Kobe, Japan | [d] Division of Metabolomics Research, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan
Correspondence:
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Corresponding author: Masaya Saito, Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe 650-0017, Japan. Tel.: +81 78 382 6305; Fax: +81 78 382 6309; E-mail:[email protected]
Abstract: BACKGROUND AND AIM: Alcoholic liver disease (ALD) is the most common cause of hepatocellular carcinoma (HCC) worldwide. Des-gamma-carboxy prothrombin (DCP) is elevated
in many patients with HCC, but also in severe alcoholics without HCC. We
aimed to clarify whether the DCP/NX-DCP ratio (NX-DCP-R) could have a high
specificity in ALD patients without HCC. METHODS: We performed a prospective cohort study on a total of 703 consecutive
outpatients of liver diseases including severe alcoholics and healthy
volunteers, who underwent blood biochemical examinations at Kobe University
Hospital. Serum DCP was measured by electrochemiluminescence immunoassay
(ECLIA) using a monoclonal antibody, MU-3. A novel parameter, serum NX-DCP,
which represents predominantly DCP caused by reduced vitamin K availability,
was also measured by ECLIA using monoclonal antibodies P-16 and P-11. The
diagnostic accuracy of DCP and NX-DCP-R in patients with and without
excessive alcohol intake was statistically examined. RESULTS: DCP was significantly higher in alcoholics than in non-alcoholics
(p= 0.005), whereas the NX-DCP-R did not differ between alcoholics and non-alcoholics
(p= 0.375). DCP was significantly increased in the serum of each patient with
alcoholic hepatitis and alcoholic cirrhosis (p< 0.05), whereas the NX-DCP-R
was not increased (p> 0.05). CONCLUSIONS: NX-DCP-R, but not DCP, was not increased in alcoholics without HCC. As for
negative screening for HCC, the specificity of the NX-DCP-R in alcoholics
without HCC was better than that of DCP in alcoholics without HCC, and so
could be a useful negative screening tool for HCC in millions of alcoholics
worldwide.
