Significance of alpha-fetoprotein combined with apolipoprotein A1 and alkaline phosphatase in the diagnosis of hepatitis B virus-related liver cancer

Objective To investigate the changes of apolipoprotein A1 （ApoA1） and alkaline phosphatase in hepatitis B virus （HBV）-related liver cancer， and evaluate the diagnostic performance of alpha-fetoprotein （AFP） combined with other indexes for HBV-related liver cancer. Methods 1 089 patients with chronic hepatitis B， compensated cirrhosis， non-compensated cirrhosis post-hepatitis B and chronic B-related liver cancer were enrolled. Among them， 745 cases were included in non-liver cancer group， and 344 cases in the HBV-related liver cancer group （liver cancer group）. The influencing factors of HBV-related liver cancer were identified by univariate and multivariate Logistic regression analyses. The area under the receiver operating characteristic （ROC） curve （AUC） was adopted to evaluate the diagnostic efficacy of AFP combined with other serological indexes in HBV-related liver cancer. Results Significant differences were observed in serum levels of ApoA1， alkaline phosphatase and AFP between the non-liver cancer and liver cancer groups （all P<0.05）. Multivariate Logistic regression analysis showed that sex， age， AFP， ApoA1 and alkaline phosphatase were the influencing factors of HBV-related liver cancer （all P < 0.05）. The AUC of the model consisting of these indexes combined for HBV-related liver cancer was 0.859， and 0.750 for AFP alone， indicating the model of these indexes combined yielded significantly higher diagnostic efficacy compared with AFP alone （P < 0.05）. Conclusions The model consisting of serum AFP， ApoA1 and alkaline phosphatase yields higher diagnostic efficacy than AFP alone. It possesses certain value for auxiliary diagnosis of HBV-related liver cancer