Page 122 - GPD-3-4

Gene & Protein in Disease PIVKA-II in differential diagnosis of AFP-NHCC

and primary liver cancer, and is significantly correlated and their diagnosis and treatment data were analyzed.
with tumor stage, malignancy, and prognosis. In recent Thirty-two patients diagnosed with AFP-NHCC were
years, a growing number of studies have been conducted included in the AFP-NHCC group, and the remaining
on inflammatory indicators in liver diseases, among which patients with non-cancerous liver diseases were included
hs-CRP was commonly used. Neutrophil–lymphocyte in the benign lesion group (58 cases). At the same time,
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ratio (NLR), a simple prognostic indicator of inflammation 45 healthy subjects who underwent physical examination
derived from routine peripheral blood tests, is the focus of were selected and classified under the healthy control
research on the inflammatory-related index, defined as the group. The baseline information is shown in Table 1. This
ratio of absolute neutrophils to lymphocytes in peripheral study has been reviewed by the Ethics Review Committee
blood. The change of NLR is an objective indicator (ethics number: 20240966).
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to judge whether the body is complicated by bacterial
infection. Cellular immunity involving lymphocytes is an 2.2. Inclusion criteria
important defense system to inhibit the occurrence and The inclusion criteria of this study are as follows:
development of tumors. Immunity involving lymphocytes (i) Presenting with symptoms such as liver pain, upper
is an important defense system to inhibit the occurrence abdominal pain, intermittent fever, and fatigue, with
and development of tumors. Studies have shown that weight loss and jaundice
NLR can better reflect the prognosis of HCC patients, (ii) AFP levels <20 µg/L
and has significant predictive value for survival and (iii) Having normal heart and kidney function, with an
recurrence of HCC patients after liver transplantation. acceptable level of liver function
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In addition to inflammation, nutritional status is also (iv) Obtained informed consent after explaining the
related to the prognosis of cancer patients. Prealbumin research purpose, process, and significance to the
(PA) is not only an inflammatory indicator, but also an
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indicator of nutritional status assessment. Moreover, patients and their families.
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some studies have shown that pre-operative albumin is 2.3. Exclusion criteria
related to the long-term prognosis of HCC patients. There
are many clinical studies on the single application of PA, The exclusion criteria of this study are as follows:
PIVKA-II, and NLR to assist in the diagnosis of primary (i) Other pathological types of liver tumors
liver cancer, 20-22 but relatively few studies on the combined (ii) Comorbidity with other tumors, metastatic tumors, or
application in the differential diagnosis of AFP-NHCC and recurrent tumors
other diseases. (iii) Severe systemic infectious diseases
(iv) Incomplete clinical data
In this paper, the efficacy of hs-CRP, NLR, and PA (v) Hepatic encephalopathy.
combined with PIVKA-II in the diagnosis of AFP-NHCC
was analyzed and reported as follows. 2.4. Methods
2. Materials and methods Patient data, including imaging reports and laboratory
reports, were collected. Peripheral venous blood samples
2.1. Baseline information collected were subjected to a series of blood indicator
Ninety patients with suspected HCC and negative AFP in measurements, such as PA using immunotransmission
Xinyang Central Hospital, Xinyang, Henan, China, were turbidimetry (PA Assay Kit, Mindray, China), hs-CRP by
recruited in this study from April 2019 to February 2023, means of rate-scattering turbidimetry, neutrophils, and

Table 1. Comparison of baseline information

Various indicators AFP‑ NHCC group (n=32) Benign lesion group (n=58) Healthy control group (n=45) χ /F/t P
2
Age (year) 58.64±4.35 57.88±5.02 57.46±4.75 0.574 0.565
Gender (male/female) 20/12 28/30 25/20 1.740 0.419
History of drinking (yes/no) 23/9 40/18 30/15 0.237 0.888
History of smoking (yes/no) 19/13 30/28 25/20 0.502 0.778
Mass diameter (cm) 1.45±1.00 1.38±1.03 - 0.312 0.756
Normal liver function (yes/no) 14/18 20/38 - 0.821 0.135
Liver cirrhosis (yes/no) 20/12 35/23 - 0.175 0.359
Abbreviation: AFP-NHCC: Alpha-fetoprotein-negative hepatocellular carcinoma.

Volume 3 Issue 4 (2024) 3 doi: 10.36922/gpd.4269