Evaluation of the effect of des-gamma-carboxy prothrombin levels on hepatocellular carcinoma development in patients with chronic hepatitis b, liver cirrhosis and hepatocellular carcinoma

Hepatocellular carcinoma (HCC) is the 7th most common cancer in the world and the 2nd most common cancer killer. At the time of diagnosis, patients are usually in advanced stages and lose curative treatment options. Therefore, the importance of early diagnosis methods continues to be important. We aimed to determine the diagnostic accuracy of des-gamma-carboxy prothrombin (DCP), which is a candidate biomarker for early diagnosis of HCC as an alternative to AFP, which is preferred in current practice, by comparing it with control groups and to reveal the relationship of conditions such as liver cirrhosis and chronic HBV infection with DCP level. Between 01/01/2023 and 30/06/2023, 16 patients with HCC, 64 patients with liver cirrhosis, 70 patients with chronic HBV infection and 95 healthy individuals without liver disease who were followed up in the Gastroenterology Clinic of Karadeniz Technical University Faculty of Medicine were voluntarily included in the study. Prospectively evaluated DCP and AFP levels were measured by ELISA method. The diagnostic parameters such as sensitivity, specificity, positive predictive value and negative predictive value of DCP, AFP and DCP+AFP for HCC were evaluated. As the DCP cut-off value, the ideal level was determined as 7 ng/mL in our study by performing ROC analysis of the DCP levels of the study participants. Similarly, the ideal level was determined as 6 mcg/L by ROC analysis of AFP levels. It was concluded that DCP may be more sensitive than AFP as a biomarker in HCC. In addition, it was shown that the use of AFP, which is routinely used in the diagnosis of HCC, together with DCP may contribute to the diagnostic process. It was concluded that the presence of cirrhosis and chronic HBV in patients may affect DCP levels. Prospective studies with a larger patient profile, especially in early stage HCC patients, may provide more comprehensive diagnostic and prognostic data and enlightening information on the clinical use of DCP. Keywords: DCP, ELISA, AFP, hepatocellular carcinoma, liver cirrhosis, chronic hbv