关键词: 肝细胞癌, 寡糖链, 甲胎蛋白, 乙型肝炎病毒

Abstract: Objective To investigate the diagnostic value of Glycan-Test in the HBV-associated hepatocellular carcinoma.Methods 435 serum samples and clinical data were collected from the patients who met the inclusion and exclusion criteria and were admitted to the First Affiliated Hospital of Nanjing Medical University from February 2017 to August 2018. Among them, 80 cases were healthy controls (HC), 105 cases were chronic hepatitis B (CHB), 60 cases were liver cirrhosis (LC), 70 cases were malignant tumors of other visceral organs, and120 cases were hepatocellular carcinoma (HCC). The relative concentration of serum oligosaccharide chain was measured by Glycan-Test kits. The levels of AFP were determined by electrochemiluminescence. Quantitative variables were presented as median (25th–75th percentiles), median values of different groups were compared by the Kruskal–Wallis H test; Qualitative variables were expressed as percentage (%) and compared by the chi-squared test; Receiver operating characteristic (ROC) curves were used to assess the diagnostic values of AFP and glycans. Results The G value in HCC group was significantly higher than that in normal group, CHB group and LC group(all P<0.001). Area under the curve (AUC) for G-Test and alpha-fetoprotein in this research were 0.882 and 0.801, respectively.There was a positive correlation between G value and AFP(P<0.001). The combined detection had significantly improved the detection efficiency of AFP (AUC = 0.928, P<0.001). The diagnostic sensitivity of G-Test alone (85.83%) in distinguishing HBV-associated HCC from BLD was significantly higher than that of AFP alone. The AUC of G-Test in distinguishing HBV-associated HCC group from non-HCC group, HC group, CHB group, and LC group were 0.901、0.938、0.897、0.857 respectively. The sensitivity of G-Test was significantly higher than that of AFP in the early diagnosis of HCC (all P<0.05). With the negative cut-off values of 20、200、400 ng/ml for AFP, the sensitivity of G-Test in detecting AFP-negative patients were 90.00%, 87.72%, 86.96%, respectively.Conclusion The diagnostic sensitivity of G-Test is superior to AFP. G-Test could be a promising assisting non-invasive biomarker for patients with HBV-associated HCC, which has better detection efficiency when combined with AFP.

Key words: Hepatocellular carcinoma, Oligosaccharide chain, Alpha fetoprotein, Hepatitis B virus