Abstract: Objective To investigate the expression levels of cytokeratin-19 (CK-19), carbohydrate antigen 50 (CA50), and alpha-fetoprotein (AFP) in patients with hepatocellular carcinoma, and to assess the utility of these biomarkers in evaluating disease progression. Methods A total of 89 patients diagnosed with hepatocellular carcinoma at Wujin Hospital of Traditional Chinese Medicine in Changzhou from February 2021 to February 2024 were included in the hepatocellular carcinoma group. Additionally, 33 patients with benign liver nodules treated during the same period were included in the benign nodule group, and 50 healthy adults served as the control group. The expression levels of CK-19, CA50, and AFP were measured, and their correlation with TNM staging was analyzed. Receiver operating characteristic (ROC) curve analysis was utilized to evaluate the diagnostic efficacy of these biomarkers in tracking disease progression. Methods Serum levels of CK-19, CA50, and AFP were significantly higher in the hepatocellular carcinoma group (18.96±5.20 ng/mL, 31.54±8.60 U/mL, and 310.16±63.14 U/L, respectively) compared to the benign nodule group (5.84±0.79 ng/mL, 15.15±3.47 U/mL, 78.26±23.58 U/L) and the reference group (2.61±0.35 ng/mL, 7.08±1.86 U/mL, 41.02±9.72 U/L; P<0.05). A trend of increasing biomarker levels from stage I to IV was observed (P<0.05). Spearman's correlation analysis showed a positive correlation between disease progression and serum levels of CK-19, CA50, and AFP (r=0.649, 0.452, 0.408; all P<0.05). The combined predictive performance of CK-19, CA50, and AFP for disease progression in hepatocellular carcinoma was high, with an AUC of 0.872, sensitivity of 80.8%, and specificity of 81.1%. Conclusion The expression levels of CK-19, CA50, and AFP are closely related to the progression of hepatocellular carcinoma and can serve as effective biomarkers for assessing disease progression.

Key words: CK-19, CA50, AFP, Hepatocellular carcinoma, Biomarkers