| Objective: To explore the diagnostic value of total bilirubin to albumin ratio (B/A ratio) combine with alpha-fetoprotein (AFP) and abnormal prothrombin induced by vitamin K absence-II (PIVKA-II) for hepatocellular carcinoma (HCC). Methods: 35 HCC patients (HCC group), 35 cirrhosis patients (cirrhosis group), 35 HCC patients post-transcatheter arterial chemoembolization (TACE) (TACE postoperative group), and 35 healthy volunteers (healthy control group) were selected in our hospital from January 2023 December 2024. The serum B/A ratio, AFP, and PIVKA-II levles were measured and compared across the groups. The correlations between serum B/A ratio, AFP, and PIVKA-II in the HCC group were analyzed. The B/A ratio, AFP, PIVKA-II were compared across different clinical and pathological features in HCC patients. The serum B/A ratio, AFP, and PIVKA-II levels were compared pre and post operation in the HCC group. The diagnostic value of B/A ratio, AFP, PIVKA-II alone and in combination for HCC were analyzed by receiver operating characteristic (ROC) curves. Results: The serum B/A ratio, AFP, and PIVKA-II levels in HCC group and TACE postoperative group were significantly higher than those in the cirrhosis group and healthy control group, and the HCC group was higher than that in the TACE postoperative group (P<0.05). Pearson correlation analysis results showed that, B/A ratio in the HCC group was positively correlated with AFP (r=0.352, P=0.001), B/A ratio was positively correlated with PIVKA-II (r=0.327, P=0.003), and AFP was positively correlated with PIVKA-II (r=0.285, P=0.008). Higher TNM stage, larger tumor diameter, presence of vascular invasion, and lower differentiation degree of HCC patients, who had higher B/A ratio, AFP, and PIVKA-II levels (P<0.05). Serum B/A ratio, AFP, and PIVKA-II levels in the HCC group post operation were significantly lower than those in pre operation (P<0.05). ROC curve analysis results showed that, when B/A ratio, AFP, and PIVKA-II were detected separately, the area under the curve (AUC) was 0.785, 0.756, and 0.802, respectively. The AUC for joint detection was 0.925. The AUC in combination was greater than that of individual detection of each indicator. Conclusion: The combination of B/A ratio, AFP, and PIVKA-II testing significantly improves the diagnostic efficiency for HCC, which provides stronger clinical diagnostic evidence. |
