Combined Analysis of Protein Induced by Prothrombin Induced by Vitamin K Absence (PIVKA) and Alpha-L-Fucosidase (AFU) with Alpha-Fetoprotein (AFP) May Improve the Diagnostic Efficacy for Liver Cirrhosis and Hepatocellular Carcinoma in Chronic Hepatitis B.

IF 2 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of General Medicine Pub Date : 2025-10-02 eCollection Date: 2025-01-01 DOI:10.2147/IJGM.S547252

Haisong Hou, Ruiqiang Weng, Liu Liang, Wendao Han

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Abstract

Background: The aim of this study was to explore the value of biomarkers such as prothrombin induced by vitamin K absence (PIVKA), osteopontin (OPN), α-L-fucoidase (AFU), interleukin-6 (IL-6), and Golgi protein 73 (GP73) in the diagnosis of chronic hepatitis B (CHB), hepatitis B liver cirrhosis (HBV-LC), and hepatocellular carcinoma (HCC).

Methods: A total of 264 male patients were included in this study, including CHB (n=88), HBV-LC (n=88), and HCC (n=88). The levels of PIVKA, OPN, AFU, alpha-fetoprotein (AFP), IL6, and GP73 of the subjects were detected respectively, and the differences in the levels of serum PIVKA, OPN, AFU, AFP, IL6 and GP73 among the groups were compared. The correlations among various indicators were analyzed, and the diagnostic value of these indicators for HBV-LC and HCC was evaluated through the receiver operating characteristic (ROC) curve analysis.

Results: The levels of PIVKA, OPN, AFP, AFU, IL6, and GP73 in patients with HBV-LC, HCC were significantly higher than those in patients with CHB, respectively. In patients with HBV-LC and HCC, no significant correlation was shown between AFP and other markers, suggesting that AFP may have an independent mechanism of action different from other markers in HBV-LC and HCC. OPN had the highest diagnostic efficacy, with an area under the ROC curve (AUC) of 0.855 in diagnosis of HBV-LC, followed by GP73 and IL6. AFU had the highest diagnostic efficacy in diagnosis of HCC, followed by AFP and OPN. In terms of combined detection, the diagnostic efficacy of AFP+AFU (AUC=0.785, 95% CI: 0.714-0.855) and AFP+PIVKA (AUC=0.635, 95% CI: 0.553-0.718) were better than AFP in diagnosing HBV-LC; and the diagnostic efficacy of AFP+AFU (AUC=0.878, 95% CI: 0.822-0.934) was better than AFP in diagnosing HCC.

Conclusion: Combined analysis of PIVKA and AFU with AFP may improve the diagnostic efficacy for HBV-LC and HCC in CHB.

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维生素K缺失致凝血酶原（PIVKA）和α - l -聚焦酶（AFU）与甲胎蛋白（AFP）联合检测可提高慢性乙型肝炎肝硬化和肝细胞癌的诊断效果。

背景：本研究旨在探讨维生素K缺失诱导的凝血酶原（PIVKA）、骨桥蛋白（OPN）、α- l -岩藻酸酶（AFU）、白细胞介素-6 （IL-6）和高尔基蛋白73 （GP73）等生物标志物在慢性乙型肝炎（CHB）、乙型肝炎肝硬化（HBV-LC）和肝细胞癌（HCC）诊断中的价值。方法：共纳入264例男性患者，包括CHB（88例）、HBV-LC（88例）和HCC（88例）。分别检测受试者的PIVKA、OPN、AFU、甲胎蛋白（AFP）、IL6、GP73水平，比较各组血清PIVKA、OPN、AFU、AFP、IL6、GP73水平的差异。分析各项指标之间的相关性，并通过受试者工作特征（ROC）曲线分析评价这些指标对HBV-LC和HCC的诊断价值。结果：HBV-LC、HCC患者PIVKA、OPN、AFP、AFU、IL6、GP73水平均显著高于CHB患者。在HBV-LC和HCC患者中，AFP与其他标志物无明显相关性，提示AFP在HBV-LC和HCC中可能具有不同于其他标志物的独立作用机制。OPN对HBV-LC的诊断效能最高，ROC曲线下面积（AUC）为0.855，其次是GP73和IL6。AFU对HCC的诊断效能最高，其次为AFP和OPN。在联合检测方面，AFP+AFU （AUC=0.785, 95% CI: 0.714-0.855）和AFP+PIVKA （AUC=0.635, 95% CI: 0.553-0.718）对HBV-LC的诊断效果优于AFP；AFP+AFU对HCC的诊断效果（AUC=0.878, 95% CI: 0.822 ~ 0.934）优于AFP。结论：PIVKA、AFU联合AFP检测可提高慢性乙型肝炎患者HBV-LC和HCC的诊断效果。

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来源期刊

International Journal of General Medicine Medicine-General Medicine

自引率

0.00%

发文量

1113

审稿时长

16 weeks

期刊介绍： The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas. A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal. As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.