Abstract: Objective To explore the changes and clinical value of serum ferritin (SF), homocysteine (Hcy), and vitamin B12 (VitB12) levels in patients with hepatitis B, cirrhosis, and primary liver cancer. Methods 98 patients diagnosed with hepatitis B virus (HBV) related liver disease in our hospital from September 2022 to November 2023 were selected as the survey subjects. Among them, there were 45 patients with liver cirrhosis after hepatitis B (Group A) and 53 patients with primary liver cancer (Group B). 42 healthy individuals who underwent physical examinations during the same period were selected as the control group.They were detected the serum levels of SF, Hcy, VitB12, and SF in each group separately, and performed correlation analysis using Pearson correlation analysis. The Receiver Operating Characteristic (ROC) curves were used to evaluate the diagnostic value of the three indicators. Results Serum total bilirubin (TBil), SF, Hcy, and VitB12 showed an increasing trend in the control group, group A, and group B (F=11.739, 20.537, 18.413, 26.709, all P<0.01), while serum Alb showed a decreasing trend (F=10.046, P<0.01). The serum levels of ALT, AST, and Alb in Group B were lower than those in Group A [(79.42±22.39)vs.(198.48±18.44),(94.93±22.25)vs.(163.93±22.25),(21.71±5.17)vs.(30.74±4.68)] (P<0.05), while the serum levels of TBil, SF, Hcy, and VitB12 were higher than those in Group A[(74.12±20.15)vs.(35.50±10.27),(469.46±105.89)vs.(266.05±71.57),(23.29±5.64)vs.(18.83±5.10),(876.68±235.16)vs.(588.91±117.39)] (P<0.05). As the Child Pugh grading increased, serum levels of ALT, AST, TBil, SF, Hcy, and VitB12 gradually increased (F=8.749, 10.073, 15.262, 9.418, 12.095, 16.639, all P<0.01), while serum Alb showed a decreasing trend (F=7.418, P<0.01). The levels of SF, Hcy, and VitB12 are correlated with ALT, AST, TBil, and negatively correlated with Alb. The area under curve (AUC = 0.955) of the combination with SF, Hcy, and VitB12 in ROC curve for predicting the risk of primary liver cancer caused by cirrhosis is the highest. Conclusion The levels of serum SF, Hcy, and VitB12 vary with the progression of the disease. Monitoring the three indicators has certain clinical value in the diagnosis and judgment of patients with hepatitis B, cirrhosis, and primary liver cancer.

Key words: Ferritin, Homocysteine, Vitamin B12, Hepatitis B cirrhosis, Primary liver cancer