Evaluation of individual and combined applications of serum biomarkers for diagnosis of Hepatocellular carcinoma: A meta-analysis

International Journal of Molecular Sciences

Volumn 14, Issue 12, 2013, Pages 23559-23580

  Hu, Bin ^a   Tian, Xiaohui ^a   Sun, Jie ^a   Meng, Xiangjun ^a,b  

^a SHANGHAI FIRST PEOPLE S HOSPITAL   (China)

^b SHANGHAI JIAO TONG UNIVERSITY AFFILIATED SIXTH PEOPLE S HOSPITAL   (China)

Author keywords

Biomarkers; Detection; Diagnosis; Hepatocellular carcinoma

Indexed keywords

ALPHA FETOPROTEIN; ALPHA FETOPROTEIN L3; BIOLOGICAL MARKER; DECARBOXYPROTHROMBIN; GOLGI PROTEIN 73; UNCLASSIFIED DRUG; GOLM1 PROTEIN, HUMAN; ISOPROTEIN; MEMBRANE PROTEIN; PROTEIN PRECURSOR; PROTHROMBIN;

ARTICLE; CANCER DIAGNOSIS; CANCER PROGNOSIS; CLINICAL PRACTICE; DECISION MAKING; DIAGNOSTIC ACCURACY; ENZYME IMMUNOASSAY; ENZYME LINKED IMMUNOSORBENT ASSAY; HUMAN; IMMUNOBLOTTING; LIVER CELL CARCINOMA; META ANALYSIS; RECEIVER OPERATING CHARACTERISTIC; SENSITIVITY AND SPECIFICITY; SURVIVAL RATE; AREA UNDER THE CURVE; BLOOD; CARCINOMA, HEPATOCELLULAR; FACTUAL DATABASE; LIVER NEOPLASMS;

ALPHA-FETOPROTEINS; AREA UNDER CURVE; BIOLOGICAL MARKERS; CARCINOMA, HEPATOCELLULAR; DATABASES, FACTUAL; HUMANS; LIVER NEOPLASMS; MEMBRANE PROTEINS; PROTEIN ISOFORMS; PROTEIN PRECURSORS; PROTHROMBIN; ROC CURVE;

EID: 84888856874     PISSN: 16616596     EISSN: 14220067     Source Type: Journal    
DOI: 10.3390/ijms141223559     Document Type: Article

References (70)

1. Stefaniuk, P.; Cianciara, J.; Wiercinska-Drapalo, A. Present and future possibilities for early diagnosis of hepatocellular carcinoma. World J. Gastroenterol. 2010, 16, 418-424.
2. Oka, H.; Tamori, A.; Kuroki, T.; Kobayashi, K.; Yamamoto, S. Prospective study of alpha-fetoprotein in cirrhotic patients monitored for development of hepatocellular carcinoma. Hepatology 1994, 19, 61-66.
3. Zoli, M.; Magalotti, D.; Bianchi, G.; Gueli, C.; Marchesini, G.; Pisi, E. Efficacy of a surveillance program for early detection of hepatocellular carcinoma. Cancer 1996, 78, 977-985.
4. Behne, T.; Copur, M.S. Biomarkers for hepatocellular carcinoma. Int. J. Hepatol. 2012, doi:10.1155/2012/859076.
5. Masuzaki, R.; Karp, S.J.; Omata, M. New serum markers of hepatocellular carcinoma. Semin. Oncol. 2012, 39, 434-439.
6. Ba, M.C.; Long, H.; Tang, Y.Q.; Cui, S.Z. GP73 expression and its significance in the diagnosis of hepatocellular carcinoma: A review. Int. J. Clin. Exp. Pathol. 2012, 5, 874-881.
7. Norton, P.A.; Comunale, M.A.; Krakover, J.; Rodemich, L.; Pirog, N.; D'Amelio, A.; Philip, R.; Mehta, A.S.; Block, T.M. N-linked glycosylation of the liver cancer biomarker GP73. J. Cell. Biochem. 2008, 104, 136-149.
8. Leerapun, A.; Suravarapu, S.V.; Bida, J.P.; Clark, R.J.; Sanders, E.L.; Mettler, T.A.; Stadheim, L.M.; Aderca, I.; Moser, C.D.; Nagorney, D.M. et al. The utility of Lens culinaris agglutinin-reactive alpha-fetoprotein in the diagnosis of hepatocellular carcinoma: Evaluation in a United States referral population. Clin. Gastroenterol. Hepatol. 2007, 5, 394-402.
9. Cedrone, A.; Covino, M.; Caturelli, E.; Pompili, M.; Lorenzelli, G.; Villani, M.R.; Valle, D.; Sperandeo, M.; Rapaccini, G.L.; Gasbarrini, G. Utility of alpha-fetoprotein (AFP) in the screening of patients with virus-related chronic liver disease: Does different viral etiology influence AFP levels in HCC? A study in 350 western patients. Hepato Gastroenterol. 2000, 47, 1654-1658.
10. Wang, C.S.; Lin, C.L.; Lee, H.C.; Chen, K.Y.; Chiang, M.F.; Chen, H.S.; Lin, T.J.; Liao, L.Y. Usefulness of serum des-gamma-carboxy prothrombin in detection of hepatocellular carcinoma. World J. Gastroenterol. 2005, 11, 6115-6119.
11. Durazo, F.A.; Blatt, L.M.; Corey, W.G.; Lin, J.H.; Han, S.; Saab, S.; Busuttil, R.W.; Tong, M.J. Des-gamma-carboxyprothrombin, alpha-fetoprotein and AFP-L3 in patients with chronic hepatitis, cirrhosis and hepatocellular carcinoma. J. Gastroenterol. Hepatol. 2008, 23, 1541-1548.
12. Giannelli, G.; Fransvea, E.; Trerotoli, P.; Beaugrand, M.; Marinosci, F.; Lupo, L.; Nkontchou, G.; Dentico, P.; Antonaci, S. Clinical validation of combined serological biomarkers for improved hepatocellular carcinoma diagnosis in 961 patients. Clin. Chim. Acta 2007, 383, 147-152.
13. Giannelli, G.; Marinosci, F.; Trerotoli, P.; Volpe, A.; Quaranta, M.; Dentico, P.; Antonaci, S. SCCA antigen combined with alpha-fetoprotein as serologic markers of HCC. Int. J. Cancer 2005, 117, 506-509.
14. Toyoda, H.; Kumada, T.; Tada, T.; Kaneoka, Y.; Maeda, A.; Kanke, F.; Satomura, S. Clinical utility of highly sensitive Lens culinaris agglutinin-reactive alpha-fetoprotein in hepatocellular carcinoma patients with alpha-fetoprotein <20 ng/mL. Cancer Sci. 2011, 102, 1025-1031.
15. Okuda, H.; Nakanishi, T.; Takatsu, K.; Saito, A.; Hayashi, N.; Watanabe, K.; Magario, N.; Yokoo, T.; Naraki, T. Measurement of serum levels of des-gamma-carboxy prothrombin in patients with hepatocellular carcinoma by a revised enzyme immunoassay kit with increased sensitivity. Cancer 1999, 85, 812-818.
16. Hsia, C.Y.; Huo, T.I.; Chiang, S.Y.; Lu, M.F.; Sun, C.L.; Wu, J.C.; Lee, P.C.; Chi, C.W.; Lui, W.Y.; Lee, S.D. Evaluation of interleukin-6, interleukin-10 and human hepatocyte growth factor as tumor markers for hepatocellular carcinoma. Eur. J. Surg. Oncol. 2007, 33, 208-212.
17. Hu, J.S.; Wu, D.W.; Liang, S.; Miao, X.Y. GP73, a resident Golgi glycoprotein, is sensibility and specificity for hepatocellular carcinoma of diagnosis in a hepatitis B-endemic Asian population. Med. Oncol. 2010, 27, 339-345.
18. Hussein, M.; Ibrahim, A.; Abdella, H.; Montasser, I.; Hassan, M. Evaluation of serum squamous cell carcinoma antigen as a novel biomarker for diagnosis of hepatocellular carcinoma in Egyptian patients. Indian J. Cancer 2008, 45, 167-172.
19. Ikoma, J.; Kaito, M.; Ishihara, T.; Nakagawa, N.; Kamei, A.; Fujita, N.; Iwasa, M.; Tamaki, S.; Watanabe, S.; Adachi, Y. Early diagnosis of hepatocellular carcinoma using a sensitive assay for serum des-gamma-carboxy prothrombin: A prospective study. Hepato Gastroenterol. 2002, 49, 235-238.
20. Ertle, J.M.; Wiehert, M.; Küper, R.; Hilgard, P.; Gerken, G.; Schlaak, J. 965 Sensitivity and specificity of Alpha-Feto Protein (Afp), Lens culinaris agglutinin-reactive Afp (Afp-L3) and des-gamma-carboxyprothrombin (Dcp) as tumor markers in patients with hepatocellular carcinoma (Hcc). J. Hepatol. 2011, 54, S385.
21. Yamamoto, K.; Imamura, H.; Matsuyama, Y.; Hasegawa, K.; Beck, Y.; Sugawara, Y.; Makuuchi, M.; Kokudo, N. Significance of alpha-fetoprotein and des-gamma-carboxy prothrombin in patients with hepatocellular carcinoma undergoing hepatectomy. Ann. Surg. Oncol. 2009, 16, 2795-2804.
22. Volk, M.L.; Hernandez, J.C.; Su, G.L.; Lok, A.S.; Marrero, J.A. Risk factors for hepatocellular carcinoma may impair the performance of biomarkers: A comparison of AFP, DCP, and AFP-L3. Cancer Biomark. 2007, 3, 79-87.
23. Mao, Y.; Yang, H.; Xu, H.; Lu, X.; Sang, X.; Du, S.; Zhao, H.; Chen, W.; Xu, Y.; Chi, T.; et al. Golgi protein 73 (GOLPH2) is a valuable serum marker for hepatocellular carcinoma. Gut 2010, 59, 1687-1693.
24. Yamamoto, K.; Imamura, H.; Matsuyama, Y.; Kume, Y.; Ikeda, H.; Norman, G.L.; Shums, Z.; Aoki, T.; Hasegawa, K.; Beck, Y.; et al. AFP, AFP-L3, DCP, and GP73 as markers for monitoring treatment response and recurrence and as surrogate markers of clinicopathological variables of HCC. J. Gastroenterol. 2010, 45, 1272-1282.
25. Marrero, J.A.; Su, G.L.; Wei, W.; Emick, D.; Conjeevaram, H.S.; Fontana, R.J.; Lok, A.S. Des-gamma carboxyprothrombin can differentiate hepatocellular carcinoma from nonmalignant chronic liver disease in american patients. Hepatology 2003, 37, 1114-1121.
26. Colombo, M. Screening for cancer in viral hepatitis. Clin. Liver Dis. 2001, 5, 109-122.
27. Nguyen, M.H.; Garcia, R.T.; Simpson, P.W.; Wright, T.L.; Keeffe, E.B. Racial differences in effectiveness of alpha-fetoprotein for diagnosis of hepatocellular carcinoma in hepatitis C virus cirrhosis. Hepatology 2002, 36, 410-417.
28. Marrero, J.A.; Feng, Z.; Wang, Y.; Nguyen, M.H.; Befeler, A.S.; Roberts, L.R.; Reddy, K.R.; Harnois, D.; Llovet, J.M.; Normolle, D.; et al. Alpha-fetoprotein, des-gamma carboxyprothrombin, and lectin-bound alpha-fetoprotein in early hepatocellular carcinoma. Gastroenterology 2009, 137, 110-118.
29. El-Shafie, M.A.; Fawzy, A.M.; Al-Monem, E.A.; Abbass, S.; Zakaria, D.M.; El-Baz, S. Golgi Protein 73 (GP73) as a novel serum marker for early detection of hepatocellular carcinoma in egyptian patients. Life Sci. J. 2012, 9, 823.
30. Morota, K.; Nakagawa, M.; Sekiya, R.; Hemken, P.M.; Sokoll, L.J.; Elliott, D.; Chan, D.W.; Dowell, B.L. A comparative evaluation of Golgi protein-73, fucosylated hemopexin, α-fetoprotein, and PIVKA-II in the serum of patients with chronic hepatitis, cirrhosis, and hepatocellular carcinoma. Clin. Chem. Lab. Med. 2011, 49, 711-718.
31. Marrero, J.A.; Romano, P.R.; Nikolaeva, O.; Steel, L.; Mehta, A.; Fimmel, C.J.; Comunale, M.A.; D'Amelio, A.; Lok, A.S.; Block, T.M. GP73, a resident Golgi glycoprotein, is a novel serum marker for hepatocellular carcinoma. J. Hepatol. 2005, 43, 1007-1012.
32. Tong, M.J.; Blatt, L.M.; Kao, V.W. Surveillance for hepatocellular carcinoma in patients with chronic viral hepatitis in the United States of America. J. Gastroenterol. Hepatol. 2001, 16, 553-559.
33. Nomura, F.; Ishijima, M.; Kuwa, K.; Tanaka, N.; Nakai, T.; Ohnishi, K. Serum des-gamma-carboxy prothrombin levels determined by a new generation of sensitive immunoassays in patients with small-sized hepatocellular carcinoma. Am. J. Gastroenterol. 1999, 94, 650-654.
34. Oka, H.; Saito, A.; Ito, K.; Kumada, T.; Satomura, S.; Kasugai, H.; Osaki, Y.; Seki, T.; Kudo, M.; Tanaka, M. Multicenter prospective analysis of newly diagnosed hepatocellular carcinoma with respect to the percentage of Lens culinaris agglutinin-reactive alpha-fetoprotein. J. Gastroenterol. Hepatol. 2001, 16, 1378-1383.
35. Ozkan, H.; Erdal, H.; Tutkak, H.; Karaeren, Z.; Yakut, M.; Yuksel, O.; Koklu, S. Diagnostic and prognostic validity of Golgi protein 73 in hepatocellular carcinoma. Digestion 2011, 83, 83-88.
36. Peng, Y.C.; Chan, C.S.; Chen, G.H. The effectiveness of serum alpha-fetoprotein level in anti-HCV positive patients for screening hepatocellular carcinoma. Hepato Gastroenterol. 1999, 46, 3208-3211.
37. Porta, C.; de Amici, M.; Quaglini, S.; Paglino, C.; Tagliani, F.; Boncimino, A.; Moratti, R.; Corazza, G.R. Circulating interleukin-6 as a tumor marker for hepatocellular carcinoma. Ann. Oncol. 2008, 19, 353-358.
38. Romeo, R.; Sangiovanni, A.; Iavarone, M.; Vavassori, S.; Della Corte, C.; Colombo, M. Diagnostic value of Lens culinaris agglutinin isoform 3 fraction (AFP-L3%) and des-gamma-carboxy prothrombin (DCP) for the diagnosis of hepatocellular carcinoma in cirrhotic patients. J. Clin. Oncol. 2010, 28, 4119.
39. Sassa, T.; Kumada, T.; Nakano, S.; Uematsu, T. Clinical utility of simultaneous measurement of serum high-sensitivity des-(gamma)-carboxy prothrombin and Lens culinaris agglutinin A-reactive a-fetoprotein in patients with small hepatocellular carcinoma. Eur. J. Gastroenterol. Hepatol. 1999, 11, 1387-1392.
40. Shi, Y.; Chen, J.; Li, L.; Sun, Z.; Zen, L.; Xu, S.; Zhang, Y.; Zhang, L. A study of diagnostic value of Golgi protein GP73 and its genetic assay in primary hepatic carcinoma. Technol. Cancer Res. Treat. 2011, 10, 287-294.
41. Shimauchi, Y.; Tanaka, M.; Kuromatsu, R.; Ogata, R.; Tateishi, Y.; Itano, S.; Ono, N.; Yutani, S.; Nagamatsu, H.; Matsugaki, S. A simultaneous monitoring of Lens culinaris agglutinin A-reactive alpha-fetoprotein and des-gamma-carboxy prothrombin as an early diagnosis of hepatocellular carcinoma in the follow-up of cirrhotic patients. Oncol. Rep. 2000, 7, 249-256.
42. Sterling, R.K.; Jeffers, L.; Gordon, F.; Venook, A.P.; Reddy, K.R.; Satomura, S.; Kanke, F.; Schwartz, M.E.; Sherman, M. Utility of Lens culinaris agglutinin-reactive fraction of alpha-fetoprotein and des-gamma-carboxy prothrombin, alone or in combination, as biomarkers for hepatocellular carcinoma. Clin. Gastroenterol. Hepatol. 2009, 7, 104-113.
43. Sun, Y.; Yang, H.; Mao, Y.; Xu, H.; Zhang, J.; Li, G.; Lu, X.; Sang, X.; Zhao, H.; Zhong, S. et al. Increased Golgi protein 73 expression in hepatocellular carcinoma tissue correlates with tumor aggression but not survival. J. Gastroenterol. Hepatol. 2011, 26, 1207-1212.
44. Tian, L.; Wang, Y.; Xu, D.; Gui, J.; Jia, X.; Tong, H.; Wen, X.; Dong, Z.; Tian, Y. Serological AFP/Golgi protein 73 could be a new diagnostic parameter of hepatic diseases. Int. J. Cancer 2011, 129, 1923-1931.
45. Trevisani, F.; D'Intino, P.E.; Morselli-Labate, A.M.; Mazzella, G.; Accogli, E.; Caraceni, P.; Domenicali, M.; de Notariis, S.; Roda, E.; Bernardi, M. Serum alpha-fetoprotein for diagnosis of hepatocellular carcinoma in patients with chronic liver disease: Influence of HBsAg and anti-HCV status. J. Hepatol. 2001, 34, 570-575.
46. Wang, M.; Long, R.E.; Comunale, M.A.; Junaidi, O.; Marrero, J.; Di Bisceglie, A.M.; Block, T.M.; Mehta, A.S. Novel fucosylated biomarkers for the early detection of hepatocellular carcinoma. Cancer Epidemiol. Biomark. Prev. 2009, 18, 1914-1921.
47. Li, X.; Wu, K.; Fan, D. Serum Golgi Phosphoprotein 2 level: A better marker than alpha-fetoprotein for diagnosing early hepatocellular carcinoma. Hepatology 2009, 50, 325-325.
48. Khien, V.V.; Mao, H.V.; Chinh, T.T.; Ha, P.T.; Bang, M.H.; Lac, B.V.; Hop, T.V.; Tuan, N.A.; Don, L.V.; Taketa, K. et al. Clinical evaluation of lentil lectin-reactive alpha-fetoprotein-L3 in histology-proven hepatocellular carcinoma. Int. J. Biol. Markers 2001, 16, 105-111.
49. Yoshida, S.; Kurokohchi, K.; Arima, K.; Masaki, T.; Hosomi, N.; Funaki, T.; Murota, M.; Kita, Y.; Watanabe, S.; Kuriyama, S. Clinical significance of Lens culinaris agglutinin-reactive fraction of serum alpha-fetoprotein in patients with hepatocellular carcinoma. Int. J. Oncol. 2002, 20, 305-309.
50. Srivastava, S.; Gopal-Srivastava, R. Biomarkers in cancer screening: A public health perspective. J. Nutr. 2002, 132, 2471S-2475S.
51. Li, D.; Mallory, T.; Satomura, S. AFP-L3: A new generation of tumor marker for hepatocellular carcinoma. Clin. Chim. Acta 2001, 313, 15-19.
52. Kladney, R.D.; Bulla, G.A.; Guo, L.; Mason, A.L.; Tollefson, A.E.; Simon, D.J.; Koutoubi, Z.; Fimmel, C.J. GP73, a novel Golgi-localized protein upregulated by viral infection. Gene 2000, 249, 53-65.
53. Taketa, K.; Okada, S.; Win, N.; Hlaing, N.K.; Wind, K.M. Evaluation of tumor markers for the detection of hepatocellular carcinoma in Yangon General Hospital, Myanmar. Acta Med. Okayama 2002, 56, 317-320.
54. Block, T.M.; Marrero, J.; Gish, R.G.; Sherman, M.; London, W.T.; Srivastava, S.; Wagner, P.D. The degree of readiness of selected biomarkers for the early detection of hepatocellular carcinoma: Notes from a recent workshop. Cancer Biomark. 2008, 4, 19-33.
55. Taketa, K.; Sekiya, C.; Namiki, M.; Akamatsu, K.; Ohta, Y.; Endo, Y.; Kosaka, K. Lectin-reactive profiles of alpha-fetoprotein characterizing hepatocellular carcinoma and related conditions. Gastroenterology 1990, 99, 508-518.
56. Wang, S.S.; Lu, R.H.; Lee, F.Y.; Chao, Y.; Huang, Y.S.; Chen, C.C.; Lee, S.D. Utility of lentil lectin affinity of alpha-fetoprotein in the diagnosis of hepatocellular carcinoma. J. Hepatol. 1996,25, 166-171.
57. Sato, Y.; Nakata, K.; Kato, Y.; Shima, M.; Ishii, N.; Koji, T.; Taketa, K.; Endo, Y.; Nagataki, S. Early recognition of hepatocellular carcinoma based on altered profiles of alpha-fetoprotein. N. Engl. J. Med. 1993, 328, 1802-1806.
58. Nouso, K.; Kobayashi, Y.; Nakamura, S.; Kobayashi, S.; Takayama, H.; Toshimori, J.; Kuwaki, K.; Hagihara, H.; Onishi, H.; Miyake, Y. et al. Prognostic importance of fucosylated alpha-fetoprotein in hepatocellular carcinoma patients with low alpha-fetoprotein. J. Gastroenterol. Hepatol. 2011, 26, 1195-1200.
59. Liebman, H.A.; Furie, B.C.; Tong, M.J.; Blanchard, R.A.; Lo, K.J.; Lee, S.D.; Coleman, M.S.; Furie, B. Des-gamma-carboxy (abnormal) prothrombin as a serum marker of primary hepatocellular carcinoma. N. Engl. J. Med. 1984, 310, 1427-1431.
60. Ishii, M.; Gama, H.; Chida, N.; Ueno, Y.; Shinzawa, H.; Takagi, T.; Toyota, T.; Takahashi, T.; Kasukawa, R. Simultaneous measurements of serum alpha-fetoprotein and protein induced by vitamin K absence for detecting hepatocellular carcinoma. South Tohoku District Study Group. Am. J. Gastroenterol. 2000, 95, 1036-1040.
61. Lamerz, R.; Runge, M.; Stieber, P.; Meissner, E. Use of serum PIVKA-II (DCP) determination for differentiation between benign and malignant liver diseases. Anticancer Res. 1999, 19, 2489-2493.
62. Mita, Y.; Aoyagi, Y.; Yanagi, M.; Suda, T.; Suzuki, Y.; Asakura, H. The usefulness of determining des-gamma-carboxy prothrombin by sensitive enzyme immunoassay in the early diagnosis of patients with hepatocellular carcinoma. Cancer 1998, 82, 1643-1648.
63. Aoyagi, Y.; Oguro, M.; Yanagi, M.; Mita, Y.; Suda, T.; Suzuki, Y.; Hata, K.; Ichii, K.; Asakura, H. Clinical significance of simultaneous determinations of alpha-fetoprotein and des-gamma-carboxy prothrombin in monitoring recurrence in patients with hepatocellular carcinoma. Cancer 1996, 77, 1781-1786.
64. Izuno, K.; Fujiyama, S.; Yamasaki, K.; Sato, M.; Sato, T. Early detection of hepatocellular carcinoma associated with cirrhosis by combined assay of des-gamma-carboxy prothrombin and alpha-fetoprotein: A prospective study. Hepato Gastroenterol. 1995, 42, 387-393.
65. Grazi, G.L.; Mazziotti, A.; Legnani, C.; Jovine, E.; Miniero, R.; Gallucci, A.; Palareti, G.; Gozzetti, G. The role of tumor markers in the diagnosis of hepatocellular carcinoma, with special reference to the des-gamma-carboxy prothrombin. Liver Transplant. Surg. 1995, 1, 249-255.
66. Okuda, H.; Nakanishi, T.; Takatsu, K.; Saito, A.; Hayashi, N.; Yamamoto, M.; Takasaki, K.; Nakano, M. Comparison of clinicopathological features of patients with hepatocellular carcinoma seropositive for alpha-fetoprotein alone and those seropositive for des-gamma-carboxy prothrombin alone. J. Gastroenterol. Hepatol. 2001, 16, 1290-1296.
67. Hamamura, K.; Shiratori, Y.; Shiina, S.; Imamura, M.; Obi, S.; Sato, S.; Yoshida, H.; Omata, M. Unique clinical characteristics of patients with hepatocellular carcinoma who present with high plasma des-gamma-carboxy prothrombin and low serum alpha-fetoprotein. Cancer 2000, 88, 1557-1564.
68. Willyard, C. Researchers look for "sweet" method to diagnose cancer. Nat. Med. 2007, 13, 1107-1267.
69. Zhou, Y.; Yin, X.; Ying, J.; Zhang, B. Golgi protein 73 versus alpha-fetoprotein as a biomarker for hepatocellular carcinoma: A diagnostic meta-analysis. BMC Cancer 2012, 12, doi:10.1186/1471-2407-12-17.
70. Littenberg, B.; Moses, L.E. Estimating diagnostic accuracy from multiple conflicting reports: A new meta-analytic method. Med Decis Making. 1993, 13, 313-321.