Abstract: Objective To investigate the diagnostic value of serum glypican-3 (GPC3) protein, peripheral blood GPC3 mRNA and combined detection in hepatocellular carcinoma (HCC). Methods The expression of GPC3 in 1 case of hepatocellular carcinoma tissue was detected by immunohistochemistry method. PubMed, Web of Science, Embase and Cochrane library databases were searched for the literature related to GPC3 diagnosis of HCC. The literature was screened according to inclusion and exclusion criteria. Data extraction and quality evaluation were performed on included literature. Meta analysis was performed using MetaDisc 1.4 software, the pooled diagnostic accuracy index was calculated, and the summary receiver operating characteristic (SROC) curve  was drawn to evaluate its diagnostic efficacy. Results The immunohistochemical results showed that GPC3 was specifically expressed in hepatocellular carcinoma. A total of 19 literatures (including 16 serum GPC3 protein articles and 5 peripheral blood GPC3MRNA articles) were further included to evaluate the diagnostic efficacy of peripheral blood GPC3 molecule for HCC, the results showed that, the pooled sensitivity, specificity and area under SROC curve of serum GPC3 protein alone in the diagnosis of HCC were 0.62 (95%CI: 0.60-0.64), 0.67 (95%CI: 0.65-0.69) and 0.75, respectively. The pooled sensitivity, specificity, area under SROC curve of GPC3 mRNA in peripheral blood were 0.76 (95%CI: 0.70-0.81), 0.87 (95%CI: 0.84-0.91) and 0.92, respectively. The sensitivity and specificity of serum GPC3 protein combined with α-fetoprotein (AFP) in the diagnosis of HCC were 0.82 (95%CI: 0.80-0.85) and 0.81 (95%CI: 0.79-0.84), respectively. Combined des-γ-carboxy prothrombin (DCP) were 0.74 (95%CI: 0.68-0.79) and 0.76(95%CI: 0.70-0.81), respectively. Conclusions GPC3 molecule is specifically expressed in hepatocellular carcinoma tissue. Compared with serum GPC3 protein, peripheral blood GPC3 mRNA may have a higher diagnostic accuracy in the diagnosis of HCC. The diagnostic efficacy of serum GPC3 protein alone is limited, whereas its combination with AFP or DCP detection can improve the diagnostic accuracy and help the early diagnosis of HCC.

Key words: Hepatocellular carcinoma, GPC3, Diagnosis, Meta-analysis