Chinese Hepatolgy ›› 2023, Vol. 28 ›› Issue (12): 1418-1422.

• Liver Failure • Previous Articles     Next Articles

The application of serum alpha fetoprotein, p62, and microtubule associated protein 1 light chain 3- Ⅱ in the prognostic evaluation of patients with HBV-related acute-on-chronic liver failure

FANG Rao-hong1, SHANG Gao-xia2, YIN Peng-yan1, ZHANG Shi-de1, CHEN Mei3, LI Qing-rong4   

  1. 1. Laboratory Medical, South Central Hospital of Yunnan Province (The First People's Hospital of Honghe State),Gejiu 661000,China;
    2. Anesthesiology operating room, South Central Hospital of Yunnan Province (The First People's Hospital of Honghe State),Gejiu 661000,China;
    3. Infectious Diseases Department, South Central Hospital of Yunnan Province (The First People's Hospital of Honghe State),Gejiu 661000,China;
    4. Laboratory Department, The Second Affiliated Hospital of Kunming Medical University, Kunming 650000, China
  • Received:2023-09-05 Online:2023-12-31 Published:2024-03-01

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Abstract: Objective To explore the application value of serum alpha fetoprotein (AFP), autophagy associated protein p62, and microtubule associated protein 1 light chain 3- Ⅱ (LC3- Ⅱ) in the prognostic evaluation of patients with HBV-related acute-on-chronic liver failure (HBV-ACLF).Methods This is a retrospective study that was conducted on 102 HBV-ACLF patients admitted from January 2020 to January 2023 in South Central Hospital of Yunnan Province as the observation group. Additionally, 50 hepatitis B patients admitted during the same period of time and 50 healthy individuals were selected as the disease control group and healthy control group, respectively. The levels of serum AFP, p62, and LC3- Ⅱ were measured and compared among three groups. The prognosis of patients in the observation group were followed up, and the serum AFP, p62 and LC3-Ⅱ levels of patients with good and poor prognosis were compared. The predictive efficacy of serum AFP, p62, and LC3- Ⅱ levels on the prognosis of HBV-ACLF patients were analyzed with the receiver operating characteristic curve (ROC) method.Results The serum AFP and LC3-Ⅱ levels were observed in the observation group>disease control group>healthy control group, and the serum p62 levels were observed in the observation group<disease control group<healthy control group. Pairwise comparisons between the groups showed statistically significant differences (P<0.05). During follow-up, 31 cases died (i.e., with poor prognosis) and 71 cases survived (i.e., with good prognosis) in the observation group, with a mortality rate of 30.39%. The serum AFP and p62 levels in the group with good prognosis were higher than those in the group with poor prognosis, whereas the serum LC3-II levels were lower than those in the group with poor prognosis (P<0.05). The ROC curve analysis showed that when the AFP value was >115.65 ng/mL, p62 >1.12 ng/mL, and LC3-Ⅱ <53.07, it had certain predictive value for the good prognosis of HBV-ACLF patients (AUC>0.7). When compared with the single use of three indicators, the combined use of three indicators had a higher diagnostic efficacy for HBV-ACLF patients with good prognosis (AUC=0.878), with diagnostic sensitivity and specificity of 92.17% and 85.68%, respectively.Conclusion Serum AFP, p62, and LC3- Ⅱ all have certain predictive value for the prognosis of HBV-ACLF patients, and the combined predictive efficacy of the three items is higher.

Key words: Alpha fetoprotein, Autophagy related proteins, Microtubule associated protein 1 light chain 3-II, Chronic hepatitis B, Acute-on-chronic liver failure