The Value of Combined Detection of Serum PIVKA-Ⅱ,AFP and HBV-DNA in the Diagnosis and Prognosis Prediction of HBV-induced Liver Cancer
Objective To explore the value of combined detection of serum protein induced by vitamin K absence or antagonist Ⅱ (PIVKA-Ⅱ),alpha-fetoprotein (AFP)and hepatitis B virus DNA (HBV DNA)in the diagnosis and prognosis of hepatocellular carcinoma (HCC)caused by HBV.Methods From August,2018 to July,2020,98 HCC patients who received treatment in our hospital were regarded as the study subjects (liver cancer group),while 95 healthy individuals who underwent physical examinations were enrolled as the healthy group,and 95 patients with liver cirrhosis were selected as the liver cirrhosis group.Serum PIVKA-Ⅱ,AFP,and HBV-DNA expression levels and general patient data among the three groups were collected and compaared.According to the 3-year prognosis of the liver cancer group,patients were separated into a survival group (57 cases)and a death group (41 cases).The general information and the relationship between serum PIVKA-Ⅱ,AFP,and HBV-DNA levels of the liver cancer group were compared and evaluated;Multivariate logistic and COX regression analyses were applied to identify potential influencing factors of liver cancer and poor prognosis,respectively;Four grid table method was applied to calculate the predictive value of serum PIVKA-Ⅱ,AFP,and HBV-DNA levels for HCC;ROC curve was drawn to evaluate the predictive value of serum PIVKA-Ⅱ,AFP,and HBV-DNA levels for the prognosis of HCC patients.Results Serum PIVKA-Ⅱ,AFP,and HBV-DNA levels in the liver cancer group were significantly higher than those in the healthy group and liver cirrhosis group (P<0.05);The incidence of HCC was related to serum PIVKA-Ⅱ,AFP,and HBV-DNA levels,and was a risk factor (P<0.05).The poor prognosis of HCC patients was related to serum PIVKA-Ⅱ,AFP and HBV-DNA levels,and the number of tumors (P<0.05),and was identified as a risk factor.The accuracy of serum PIVKA-Ⅱ,AFP,HBV-DNA levels,and their combination in diagnosing HCC were 77.43％,72.57％,77.43％,and 84.72％,respectively.The efficacy of the three combined diagnoses was better than that of the single-marker diagnosis (P<0.05).AUC values of serum PIVKA-Ⅱ,AFP,HBV-DNA levels,and their combination in diagnosing poor prognosis of HCC were 0.823,0.841,0.824,and 0.958,respectively.The efficacy of the three-marker combined diagnosis was superior to that of the single-marker diagnosis (P<0.05).Conclusion Serum PIVKA-Ⅱ,AFP,and HBV-DNA are highly expressed in HCC patients and patients with poor prognosis,and their combination can effectively predict the onset and prognosis of HCC.
Liver cancerProtein induced by vitamin K absence or antagonist ⅡAlpha fetoproteinHepatitis B virus DNADiagnosisPrognosis
万方数据
维普
