Perspectives on using des-γ-carboxyprothrombin (DCP) as a serum biomarker: facilitating early detection of hepatocellular carcinoma in China

Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related deaths in China.Evidence has shown that surgical resection and liver transplantation may offer the best potential for treatingHCC but are only available to patients whose tumors are detected early. Over the past few decades, althougha series of measures for standardized management of HCC has been implemented in China, most patientswith HCC in China still present with advanced-stage disease, thus strategies to screen for and diagnoseHCC at an earlier stage are urgently needed in China when curable interventions can be offered to achievelong-term disease-free survival for patients with HCC. In China, the serum biomarker α-fetoprotein (AFP)is considered a useful and feasible tool for HCC screening and early diagnosis. However, the sensitivity andspecificity of AFP vary widely, and the total AFP is not always specific, especially when HCC is in its earlystages. Globally, numerous studies have reported that the combination of des-γ-carboxyprothrombin (DCP)and AFP may have a higher sensitivity than AFP alone, and suggested DCP could also be used to assess the progression of HCC. However, DCP has not been approved in China until now. Differ from most ofWestern countries, people with HBV infection are the largest population at risk of developing HCC China.In order to assess the screening and diagnostic value of DCP in Chinese patients with HCC, a first largescale,multi-center study was launched in China in 2012, results showed that DCP can help to detect HCCin its early stages and facilitate definitive treatment. The clinical use of DCP is urgently needed to facilitateearly detection of HCC in China.