Abstract: Objective The aim of the present study was to investigate the serum levels of DNA methyltransferase 1 (DNMT1) and Mac-2 binding protein glycosylation isoform (M2BPGi) in patients with primary hepatocellular carcinoma (PLC) and their relationship with the patients′prognosis. Methods Seventy-nine PLC patients who underwent hepatectomy for hepatocellular carcinoma treatment in Tangshan People′s Hospital from May 2020 to May 2021 were retrospectively selected as the study group. Another 37 cases of healthy people for physical examination at the same period of time were selected as the control group. The serum levels of DNMT1 and M2BPGi in subjects of the two study groups were compared and analyzed for their relationship with the clinicopathological characteristics of the PLC patients. The diagnostic efficacy of serum DNMT1 and M2BPGi levels for the occurrence of PLC was assessed using the subjects′ working curves (ROC) and the areas under the curves (AUC). The diagnostic efficacy of serum DNMT1 and M2BPGi levels for the occurrence of PLC was assessed using the Kaplan-Meier curve method. Log-rank test were used to analyze the relationship between the serum DNMT1 and M2BPGi levels and the prognosis of the PLC patients. The risk factors affecting the prognosis of PLC patients were analyzed by univariate and multivariate Cox regression method. Results The levels of serum DNMT1 and M2BPGi in PLC patients of the study group were (2.98±1.57) ng/mL and (3.68±2.07) mg/mL respectively, which were significantly higher than those of (0.67±0.23) ng/mL and (0.52±0.26) mg/mL in the control group (P<0.05). The serum DNMT1 and M2BPGi levels were associated with clinicopathological features such as tumor diameter, the presence of cirrhosis, the presence of lymph node metastasis, and the presence of vascular invasion (P<0.05). The results of the ROC curves showed that serum DNMT1 and M2BPGi levels for predicting PLC occurrence had AUCs of 0.708 and 0.799, sensitivities of 64.62% and 74.72%, and specificities of 71.26% and 75.98%, respectively. The combined prediction of the above indexes for PLC occurrence had an AUC of 0.923, a sensitivity of 86.14%, and a specificity of 91.29%. The AUC of the combined prediction was significantly higher than that of DNMT1 (Z=4.615, P<0.001) and M2BPGi (Z=3.382, P<0.001) used alone (P<0.05). The results of the Kaplan-Meier survival curve analysis showed that the overall survival rate of patients with PLC who had high levels of serum DNMT1 and M2BPGi (4.35% and 6.12%) was significantly lower than that of patients with low levels of serum DNMT1 and M2BPGi (21.21% and 20.00%, P<0.05); the results of multifactorial Cox regression analysis showed that the tumor diameter (≥5 cm), the presence of cirrhosis, the presence of lymph node metastasis, the presence of vascular invasion, and the high expression levels of DNMT1 and M2BPGi were independent risk factors associated with poor prognosis (P<0.05). Conclusion Serum DNMT1 and M2BPGi levels were high in PLC patients, and their serum levels were closely related to the poor prognosis of PLC patients, which may be used as an effective indicator to evaluate the poor prognosis of PLC patients.

Key words: Primary hepatocellular carcinoma, DNMT1, M2BPGi, Prognosis