The serum AFP, AFP-L3, and PIVKA-Ⅱ levels in patients with hepatitis B-related cirrhosis and their relationship with the occurrence of liver cancer

Abstract

Abstract: Objective This study aimed to investigate the serum levels of alpha-fetoprotein (AFP), alpha-fetoprotein isoform (AFP-L3), and protein induced by vitamin K absence or antagonist-Ⅱ (PIVKA-Ⅱ) in patients with hepatitis B-related cirrhosis and to analyze their relationship with the occurrence of liver cancer. Methods This retrospective study included 245 patients with hepatitis B-related cirrhosis admitted to our hospital between January 2015 and December 2019. The patients were followed up for 4 years. Based on the follow-up outcomes, they were divided into a liver cancer group (37 cases) and a liver cirrhosis group (208 cases). Compare the levels of serum AFP, AFP-L3 and PIVKA-Ⅱ in the two groups of patients. The predictive performance was evaluated by receiver operating characteristic (ROC) curve analysis, and the independent risk factors were analyzed using multivariate logistic regression. Results The levels of serum AFP, AFP-L3 and PIVKA-Ⅱ in the liver cancer group were (198.65 ± 59.47) ng/mL, (21.86 ± 3.22)% and (385.75 ± 91.63) mAU/mL respectively, which were significantly higher than those in the liver cirrhosis group [(25.26 ± 8.37) ng/mL, (7.24 ± 1.95)% and (56.92 ± 15.26) mAU/mL respectively, P<0.05]. The areas under the curves for predicting the occurrence of liver cancer by serum AFP, AFP-L3, and PIVKA-Ⅱ alone and in combination were 0.849, 0.866, 0.763, and 0.941, respectively; the sensitivities were 0.761, 0.789, 0.737, and 0.842, respectively; and the specificities were 0.779, 0.794, 0.750, and 0.868, respectively (P<0.05). The results of the logistic regression analysis indicated that for patients with hepatitis B-related liver cirrhosis, serum AFP, AFP-L3, and PIVKA-Ⅱ were independent risk factors for the occurrence of liver cancer (P<0.05). Conclusion For patients with hepatitis B-related liver cirrhosis, elevated levels of serum AFP, AFP-L3 and PIVKA-Ⅱ can increase the risk of liver cancer. Monitoring these three serum markers is helpful in identifying high-risk individuals for liver cancer occurrence.

Key words: Hepatitis B cirrhosis, Liver cancer , Alpha-fetoprotein , Alpha-fetoprotein isoform , Protein induced by vitamin K absence or antagonist-Ⅱ

Zhang Jiaojiao, Han Ning, Xue Caimei. The serum AFP, AFP-L3, and PIVKA-Ⅱ levels in patients with hepatitis B-related cirrhosis and their relationship with the occurrence of liver cancer[J]. Chinese Hepatolgy, 2026, 31(7): 962-965.

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