Combined Analysis of Protein Induced by Prothrombin Induced by Vitamin K Absence (PIVKA) and Alpha-L-Fucosidase (AFU) with Alpha-Fetoprotein (AFP) May Improve the Diagnostic Efficacy for Liver Cirrhosis and Hepatocellular Carcinoma in Chronic Hepatit

Haisong Hou,1 Ruiqiang Weng,2 Liu Liang,3 Wendao Han1 1Department of Blood Transfusion, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China; 2Institute of Basic Medical Sciences, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China; 3Department of Laboratory Medicine, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of ChinaCorrespondence: Haisong Hou, Department of Blood Transfusion, Meizhou People’s Hospital, Meizhou Academy of Medical Sciences, Meizhou, People’s Republic of China, Email [email protected]: The aim of this study was to explore the value of biomarkers such as prothrombin induced by vitamin K absence (PIVKA), osteopontin (OPN), α-L-fucoidase (AFU), interleukin-6 (IL-6), and Golgi protein 73 (GP73) in the diagnosis of chronic hepatitis B (CHB), hepatitis B liver cirrhosis (HBV-LC), and hepatocellular carcinoma (HCC).Methods: A total of 264 male patients were included in this study, including CHB (n=88), HBV-LC (n=88), and HCC (n=88). The levels of PIVKA, OPN, AFU, alpha-fetoprotein (AFP), IL6, and GP73 of the subjects were detected respectively, and the differences in the levels of serum PIVKA, OPN, AFU, AFP, IL6 and GP73 among the groups were compared. The correlations among various indicators were analyzed, and the diagnostic value of these indicators for HBV-LC and HCC was evaluated through the receiver operating characteristic (ROC) curve analysis.Results: The levels of PIVKA, OPN, AFP, AFU, IL6, and GP73 in patients with HBV-LC, HCC were significantly higher than those in patients with CHB, respectively. In patients with HBV-LC and HCC, no significant correlation was shown between AFP and other markers, suggesting that AFP may have an independent mechanism of action different from other markers in HBV-LC and HCC. OPN had the highest diagnostic efficacy, with an area under the ROC curve (AUC) of 0.855 in diagnosis of HBV-LC, followed by GP73 and IL6. AFU had the highest diagnostic efficacy in diagnosis of HCC, followed by AFP and OPN. In terms of combined detection, the diagnostic efficacy of AFP+AFU (AUC=0.785, 95% CI: 0.714– 0.855) and AFP+PIVKA (AUC=0.635, 95% CI: 0.553– 0.718) were better than AFP in diagnosing HBV-LC; and the diagnostic efficacy of AFP+AFU (AUC=0.878, 95% CI: 0.822– 0.934) was better than AFP in diagnosing HCC.Conclusion: Combined analysis of PIVKA and AFU with AFP may improve the diagnostic efficacy for HBV-LC and HCC in CHB.Keywords: chronic hepatitis B, liver cirrhosis, hepatocellular carcinoma, prothrombin induced by vitamin K absence, alpha-L-fucosidase