Abstract: Objective To explore the diagnosis value of serum protein induced by vitamin K absence/antagonist-Ⅱ and alpha-fetoprotein-L3 ratio in HBV-related hepatocellular carcinoma(HCC) patients with negative AFP. Method 86 cases with HCC and 69 cases with benign liver disease and 56 cases with control group were enrolled in Shenzhen Third People's Hospital from January 2018 to October 2021. Serum PIVKA-Ⅱ and AFP-L3% were measured and statistically analyzed. Receiver operating characteristic (ROC) curve was drawn to analyze the diagnostic efficacy of PIVKA-Ⅱ and AFP-L3% alone and in combination for AFP negative HBV-related HCC. Result Serum PIVKA-Ⅱ and AFP-L3% were significantly different among the three groups (P<0.05). PIVKA-Ⅱ and AFP-L3% in HCC group were higher than those in benign liver disease group and control group (P<0.05); Serum PIVKA-Ⅱ had a sensitivity of 54.7% and a specificity of 91.2% in the diagnosis of HBV-related HCC with negative AFP, while AFP-L3% had a sensitivity of 60.5% and a specificity of 84.0%. The combination between PIVKA-Ⅱ and AFP-L3% have a higher sensitivity(74.7%). Conclusion PIVKA-Ⅱ and AFP-L3% are both having diagnosis value in AFP negative HBV-related HCC. Combined detection between AFP-L3% and DCP can improve the diagnostic efficiency in AFP negative HBV-associated HCC, and provide theoretical basis for the early diagnosis of AFP negative HBV-associated HCC.

Key words: Protein induced by vitamin K absence/antagonist-Ⅱ, alpha-fetoprotein-L3 ratio, Hepatitis B virus, Hepatocellular carcinoma