TÌM HIỂU GIÁ TRỊ CHẨN ĐOÁN UNG THƯ GAN CỦA CÁC DẤU ẤN PIVKA II, AFP-L3 TRÊN BỆNH NHÂN XƠ GAN VÀ UNG THƯ GAN CÓ HBsAg (+)

Abstract

Objective: To investigate the diagnostic value ofliver cancer markers PIVKA II and AFP-L3  in cirrhotic  and liver cancer patients with HBsAg (+).

Subjects and study methods: Cross-sectional descriptive study was performed on 141HBsAg(+) patients, including 55 ones  diagnosed with cirrhosis and 86 ones with liver cancer, and treated at National Hospital for Tropical Diseases from January 2018 to July 2020.

Results: In the group of patients with liver cancer, the concentration of PIVKA-II and the rate of AFP-L3 significantly increased compared to the group of patients with cirrhosis (p <0.05). With a cut-off point of 14.05, the sensitivity and specificity of AFP-L3 in diagnosis of liver cancer was 68.6%; 70.9%; for PIVKA-II with a cut-off point of 104 the sensitivity and specificity were 86% and 90.9% respectively. In the group of 23 HCC patients with AFP <20ng / ml, the rate of AFP-L3 increasing at more than 10% accounted for 60.9%, also in this group the proportion of patients with PIVKA-II concentrations ≥ 40 mAU / ml accounted for 87%. Thus, at very low AFP concentration<20ng / ml, two markers AFP-L3 and PIVKA-II have the ability to detect liver cancer early.

Conclusion: AFP-L3 and PIVKA-II markers help early detection of liver cancer in HBsAg (+) patients.