The correlation between serum PIVKA-II level and liver function in patients with hepatitis B-associated liver cancer

Abstract

Abstract: Objective The abnormal serum PIVKA-II level and liver function in patients with hepatitis B-associated liver cancer were observed and the correlation was analyzed. Methods A total of 137 chronic hepatitis B patients who were enrolled between April 2020 and April 2023 were taken as the chronic hepatitis B group; 35 patients with hepatitis B related cirrhosis admitted during the same period of time were selected as the cirrhosis group; 67 patients with hepatitis B-related liver cancer admitted during the same period of time were selected as the liver cancer group; and 51 healthy subjects who underwent physical examination during the same period of time were selected as the control group. The new industry MAGLUMI X8 chemiluminescence analysis was used to detect the serum PIVKA-Ⅱ level, detect liver function indicators, and ROCHE cobas6000 E602 electrochemiluminescence immunoassay was used to detect alpha fetoprotein (AFP). Graphpad Prism was used to analyze the serum PIVKA-Ⅱ level in the diagnosis of hepatitis B-related liver cancer. Results The levels of serum PIVKA-Ⅱ and AFP were 21.0 (18.0~27.0) and 2.1(1.7~3.3) ng/mL respectively in the control group, 22.0 (12.0~28.0) and 2.3 (1.7~3.4) ng/mL in the chronic hepatitis B group, and 21.0 (15.0~46.0) and 2.5 (1.7~4.0) ng/mL in the cirrhosis group, which were significantly lower than those of 61.1 (22.0~2021.0) and 6.2 (2.5~76.8) ng/mL in the liver cancer group (P<0.05); The serum ALT level in the control group was 16.0 (13.0~26.0)U/L, which was significantly lower than those of 30.0 (18.3~44.0)U/L in the chronic hepatitis B group, 31.5 (20.0~47.3)U/L in cirrhosis group, and 30.5 (20.0~54.0)U/L in liver cancer group [P<0.05]. The serum AST and GGT levels were 19.0 (16.0~22.0) U/L and 24.0 (17.0~35.0) U/L respectively in the control group, 24.0 (20.0~31.0) U/L and 25.5 (17.0~41.7) U/L in the chronic hepatitis B group, which were significantly lower than those of 31.5 (25.0~52.3) U/L, and 53.5 (23.8~99.0) U/L in the cirrhosis group [P<0.05], and 31.5 (21.5~60.0) U/L, and 60.0 (25.8~135.5) U/L in the liver cancer group, [P<0.05]. Spearman correlation analysis showed that serum PIVKA-Ⅱ was positively correlated with AST, GGT and AFP levels (P<0.05) (r=0.173, P=0.004; r=0.323, P<0.001; r=0.286, P<0.001). Using Graphpad prism analysis, compared with the control group, the area under the curve was 0.7523, P<0.05, and the optimal diagnostic cutoff value was 41.00 ng/mL; compared with the chronic hepatitis B group, the area under the curve of PIVKA-Ⅱ was 0.7630, and the optimal diagnostic cutoff value was 43.50 ng/mL. Conclusion The serum PIVKA-Ⅱ level in patients with hepatitis B-related liver cancer is significantly higher than that in patients with hepatitis B and hepatitis B-related cirrhosis, which may have higher diagnostic efficacy for hepatitis B-related liver cancer, and can be used as a reference for clinical diagnosis of hepatitis B-related liver cancer.

Key words: Chronic hepatitis B, Cirrhosis of the liver, Liver cancer, Abnormal prothrombin, Liver function

KONG Wei-ju, REN Chuan-lu, ZHOU Yu-qi, LI Jing-zheng, HE Qing, YUAN Jun-fei. The correlation between serum PIVKA-II level and liver function in patients with hepatitis B-associated liver cancer[J]. Chinese Hepatolgy, 2024, 29(7): 794-797.

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