Abstract: Objective To investigate theapplication value of combined detection of serum autophagy-associated proteins [p62 and microtubule-associated protein 1 light chain 3-II (LC3-II)] in predicting short-term prognosis of patients with hepatitis B virus related acute-on-chronic liver failure (HBV-ACLF).Methods A total of 78 HBV-ACLF patients (ACLF group) admitted to our hospital from September 2016 to September 2018 were enrolled. And 42 healthy people who underwent physical examination in the same period were enrolled as control group. Fasting venous blood in the morning of both groups was collected. Total bilirubin, creatinine and international normalized ratio were measured. The scores of the model for end-stage liver disease (MELD) were calculated. Enzyme-linked immunosorbent assay was applied to measure levels of serum p62 and LC3-II. The clinical outcomes within 3 months after admission were recorded. The receiver operating characteristic (ROC) curves were applied to evaluate predicting efficiency of serum p62 and LC3-II for prognosis of HBV-ACLF patients.Results The level of serum LC3-II in ACLF group was significantly higher than that in control group [(68.35±16.07) ng/ml vs (37.96±11.50) ng/ml], while p62 level was lower than that in control group [(2.30±1.45) ng/ml vs (4.63±2.38) ng/ml] (P< 0.05). The results of Pearson correlation analysis showed that serum p62 was negatively correlated with MELD score (r=-0.383, P< 0.05), while serum LC3-II was positively correlated with MELD score (r=0.458, P< 0.05). ROC curves confirmed that optimal cut-off values of p62 and LC3-II for predicting short-term prognosis of HBV-ACLF patients were 1.51 ng/ml and 80.74 ng/ml, respectively. The area under the ROC curve (AUC) of their combined prediction was greater than that of p62 or LC3-II alone [0.813 (95% confidence interval: 0.710-0.892) vs 0.727 (95% confidence interval: 0.616-0.821), 0.736 (95% confidence interval: 0.626-0.828)] (P< 0.05). There was no significant difference in AUC between p62 and LC3-II for predicting prognosis of HBV-ACLF (P>0.05).Conclusion There is certain value of serum p62 and LC3-II in predicting short-term prognosis of patients with HBV-ACLF. The combined detection has better predictive value.

Key words: p62, Microtubule-associated protein 1 light chain 3-II, Hepatitis B virus related acute-on-chronic liver failure, Prognosis