Abstract: Objective To investigate the serum levels of a disintegrin and metalloproteinase with thrombospondin motifs 13 (ADAMTS13), growth differentiation factor-15 (GDF-15), and angiopoietin-like protein 6 (ANGPTL6) in patients with hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC) and their correlation with HCC. Methods Eighty patients with HBV-related HCC admitted to Nanjing Lishui People's Hospital and Nanjing Gaochun People's Hospital between June 2020 and December 2023 were selected as the observation group, and 80 patients with chronic HBV infection during the same period were selected as the control group. General data, and serum levels of ADAMTS13, GDF-15, and ANGPTL6 of the two groups were compared. Multivariate logistic analysis was used to identify the risk factors associated with the HBV-related HCC, and the diagnostic value of each factor in predicting HCC occurrence was assessed by receiver operating characteristic (ROC) curves. Results The serum levels of ADAMTS13, GDF-15, and ANGPTL6 in the observation group were (975.15±191.60) ng/mL, (1.61±0.29) ng/mL, and (163.66±47.40) ng/mL, respectively, lower than those in the control group [(1 140.63±158.34) ng/mL, (2.03±0.43) ng/mL, and (199.58±44.86) ng/mL]. Logistic regression analysis showed that low levels of ADAMTS13, GDF-15, and ANGPTL6, and high levels of HBV DNA, were independent risk factors for the occurrence of HBV-related HCC (P<0.05). ROC curve analysis indicated that the sensitivity of ADAMTS13, GDF-15, and ANGPTL6 in predicting HCC occurrence in chronic HBV-infected patients was 52.5%, 73.8%, and 65.0%, respectively. The specificity was 88.7%, 71.3%, and 71.3%, respectively, with are under the curve (AUC) of 0.745, 0.787, and 0.711. When ADAMTS13, GDF-15, and ANGPTL6 were combined for prediction, the sensitivity and specificity increased to 70.0% and 88.7%, respectively, with an AUC of 0.878. Conclusion Serum levels of ADAMTS13, GDF-15, and ANGPTL6 are significantly reduced in patients with HBV-related HCC, and the expression levels of these biomarkers are closely related to the occurrence of HCC. Dynamic monitoring of these markers may contribute to the early warning and prognosis of HCC.

Key words: Hepatitis B virus, Hepatocellular carcinoma, A disintegrin and metalloproteinase with thrombospondin motifs 13, Growth differentiation factor-15, Angiopoietin-like protein 6