ABSTRACT:

Background and aim: Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related deaths worldwide. It is curable in the early stages but has a poor prognosis when advanced. Current diagnostic protocols for the early stages of HCC are inefficient. Serum Glypican-3 (GPC-3) is a promising serum tumour marker in diagnosing HCC, and its diagnostic value has been explored in various studies. The outcomes, however, continue to be inconsistent and controversial. This systematic review and meta-analysis aimed to investigate the diagnostic accuracy of serum GPC-3 in hepatocellular carcinoma. This study included recent papers not captured in previous meta-analyses.

Method: PUBMED, MEDLINE, Cochrane Library, and CINAHL databases were systematically searched according to preferred reporting items for a systematic review and meta-analysis of diagnostic test accuracy studies guidelines. Studies on the diagnostic accuracy of serum GPC-3 in HCC were selected. The Quality assessment of diagnostic accuracy studies 2 (QUADAS-2) tools were used to assess the quality of selected studies. Sensitivity, specificity, and other diagnostic parameters were pooled using the random effect model. The Summary receiver operating characteristic (sROC) was used to summarise the diagnostic accuracy of Serum GPC-3.

Results: Eleven studies were included in this systematic review. The pooled sensitivity, specificity, and 95% confidence intervals (CIs) were 0.60 (0.57-0.62) and 0.67(0.64-0.70), respectively. The pooled positive and negative likelihood ratios and 95% CIs were 2.11 (1.51-2.93) and 0.59 (0.51-0.68), respectively; the pooled diagnostic odds ratio and the 95% CI were 4.07 (2.37-6.98), the area under the sROC curve was 0.7194.

Conclusion: This meta-analysis has shown that Serum GPC-3 has an acceptable diagnostic value in diagnosing HCC compared to benign chronic liver diseases. A higher-quality study with a larger sample size is necessary to thoroughly assess the diagnostic utility of serum GPC-3.

KEYWORDS:

Glypican 3, Chronic liver diseases, Diagnostic accuracy, HCC, Biomarker.

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