Diagnostic Value of Combined Serum Marker Tests in Hepatitis B Virus-Associated Hepatocellular Carcinoma.

OBJECTIVE

To investigate the diagnostic significance of the combination of alpha-fetoprotein (AFP), serum abnormal prothrombin (PIVKA-II), and α-L-Fucosidase (AFU) in hepatocellular carcinoma (LC).

METHODS

A total of 580 cases of chronic hepatitis B patients were collected, including 124 cases of hepatitis B-related liver cancer patients treated in our hospital from March 2021 to December 2022, 325 cases of simple chronic hepatitis B patients, and 189 cases of hepatitis B cirrhosis patients from our hospital in the same period. We measured serum levels of AFP, PIVKA-II, and AFU using ELISA. Statistical analysis was performed using SPSS software, employing t tests, ANOVA. ROC curves were used to assess the effectiveness of the three markers alone and in combination for screening hepatitis B-associated liver cancer from patients with chronic hepatitis B.

RESULTS

The serum levels of AFP and PIVKA-II were significantly higher in the hepatitis B liver cancer group compared to the cirrhotic hepatitis B group and the chronic hepatitis B group, with statistically significant differences (P < .05). The AFU level in the hepatocellular carcinoma group was also significantly higher than that in the chronic hepatitis B group (P < .05). When individually tested, the AUC of PIVKA-II was the largest, followed by AFP, and AFU had the smallest AUC (P < .05). When combined, the AUC was the greatest, reaching XX, outperforming individual markers alone or their combinations. This suggests that combining AFP, AFU, and PIVKA offers improved sensitivity (86.5%) and specificity (97.8%) for liver cancer diagnosis. These findings indicate the potential clinical relevance of utilizing these biomarkers together for accurate detection and monitoring of liver cancer.

CONCLUSION

The combination of AFP, AFU, and PIVKA-II demonstrates improved diagnostic accuracy in early detection of hepatitis B-related hepatocellular carcinoma, particularly in patients with chronic hepatitis B complicated by cirrhosis. These findings have significant clinical implications, as early diagnosis enables timely intervention and treatment, potentially improving patient outcomes and guiding appropriate therapeutic strategies for affected individuals.