| Objective:To investigate the diagnostic value of serum oligosaccharide chain test(G-test),alpha-fetoprotein(AFP),alpha-L-fucosidase(AFU)alone and in combination in hepatitis B virus(HBV)-related hepatocellular carcinoma(HCC).Methods:From June 2020 to June 2021,we collected the serologic examination results and clinical information of 341 patients treated in Shandong Provincial Hospital.There were 128 patients with HBV-associated HCC and 200 patients with benign liver disease included in the study,and 13 with interference were excluded.According to tumor size and serum level of HBV DNA,HBV-related HCC patients were divided into the following categories:HCC patients,Small HCC patients,HBV DNA positive(HBV DNA+)HCC patients,and HBV DNA negative(HBV DNA-)HCC patients.Based on the variables selected,the logistic regression models were established,and receiver operating characteristic(ROC)curves were plotted.The ability of G-Test,AFP,and AFU to identify different types of HBV-associated HCC was compared by calculating the areas under the ROC curve(AUCs).Results:1.The serum levels of G-test,AFP,and AFU in the HCC group were significantly higher than those in the BLD group,the differences were statistically significant(P<0.001).2.The AUC of the three tumor markers for the independent diagnosis of HCC in descending order were G-test,AFU,and AFP,corresponding to 0.84(95%CI 0.80-0.89),0.79(95%CI 0.74-0.85),and 0.75(95%CI 0.70-0.81),respectively.The AUC of the G-test was significantly higher than that of AFP(P<0.05),but there was no statistical difference between the AUC of the G-test and that of AFU(P>0.05).There was no significant difference between AFP and the AUC of AFU(P>0.05).The combination of the three biomarkers resulted in an AUC of 0.93(95%CI:0.90-0.96),which was significantly higher than the AUC values for each biomarker alone or that of the combined diagnosis of the two markers.3.The AUC of the three tumor markers for the independent diagnosis of small HCC in descending order were G-test,AFU,and AFP,corresponding to 0.81(95%CI 0.76-0.87),72(95%CI 0.65-0.80),and 0.63(95%CI 0.56-0.70),respectively.The AUC of the G-test was significantly higher than that of AFP(P<05),The AUC of AFU was not significantly different from that of the G-test and AFP(P>0.05).The combination of the G-test and AFU for Small HCC resulted in an AUC of 0.89(95%CI:0.84-0.93),which was significantly higher than the AUC values for each biomarker alone or the G-test combined with AFP or AFP combined with AFU(P<0.05).The AUC of AFP and AFU in the diagnosis of small HCC was significantly lower than that in the diagnosis of HCC(P<0.05),while there was no statistical significance in the change of AUC in the G-test(P>0.05).4.The AUC of the three tumor markers for the independent diagnosis of HCC in descending order were G-test,AFP,and AFU,corresponding to 0.84(95%CI 0.78-0.90),80(95%CI 0.73-0.86),0.79(95%CI 0.72-0.87)respectively.There was no statistical significance in the AUC of the G-test compared with AFP and AFU(P>0.05).There was no significant difference between AFP and the AUC of AFU(P>0.05).The combination of the three biomarkers resulted in an AUC of 0.93(95%CI:0.89-0.97),which was significantly higher than the AUC values for each biomarker alone or that of the combined diagnosis of the two markers.5.The AUC of the three tumor markers for the independent diagnosis of HBV negative HCC in descending order were G-test,AFU,and AFP,corresponding to 0.79(95%CI 0.72-0.87),76(95%CI 0.67-0.85),and 0.65(95%CI 0.57-0.73),respectively.The AUC of the G-test was significantly higher than that of AFP(P<0.05).The AUC of AFU was not significantly different from that of the G-test(P>0.05).The combination of the G-test and AFU for HBV negative HCC resulted in an AUC of 0.89(95%CI:0.84-0.95),which was significantly higher than the AUC values for each biomarker alone or the G-test combined with AFP or AFP combined with AFU(P<0.05).The AUC of AFP in the diagnosis of HBV negative HCC was significantly lower than that in the diagnosis of HBV positive HCC(P<0.05),while there was no statistical significance in the change of AUC in the G-test and AFU(P>0.05).Conclusion:1.The serum levels of G-test,AFP,and AFU in the HCC group were significantly higher than those in the BLD group,suggesting that elevated serum levels of tumor markers indicate the deterioration of the disease.Therefore,a further comprehensive examination is needed when tumor markers are elevated in the HCC high-risk group.2.The combination of the G-test,AFP,and AFU in the diagnosis of HCC can achieve the best diagnostic value,indicating that the G-test and AFU can be used as a supplement to AFP,which is a traditional tumor marker.Meanwhile,the combination of multiple tumor markers has good clinical application value.3.Compared with AFP,the G-test is a more suitable tumor marker for sHCC diagnosis,which provides a prerequisite for early intervention and is worthy of further clinical application.4.When HCC patients were HBV-DNA positive,there was no significant difference in the diagnostic value of any tumor markers,and combined application could further improve the diagnostic accuracy.5.When HBV-DNA of HCC patients is negative,AFP has less diagnostic value and more false negatives.In this case,the combination of G-test and AFU can be considered for diagnosis,which can effectively avoid the missed diagnosis of these patients. |
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