NGHIÊN CỨU SỰ THAY ĐỔI VÀ TƯƠNG QUAN NỒNG ĐỘ CÁC DẤU ẤN PIVKA II, AFP-L3 VÀ AFP TRÊN BỆNH NHÂN UNG THƯ GAN CÓ HBsAg(+)

Abstract

Study objective: to study the change and the correlation between markers PIVKA-II, AFP-L3 and AFP in HCC patients having HbsAg(+). Subjects and methods: A cross-sectional descriptive study was conducted on 86 patients with hepatocarcinoma who had HbsAg (+) and were treated at the National Hospital for Tropical Diseases from 1/2018 to July 2020. Results:  Among 86 HCC patients with HBsAg(+), only 50% had AFP >200ng/ml. The percentage of patients with AFP-L3 and PIVKA-II values ​​elevated above the normal limit accounted for 60.7% and 87.8%, respectively. Patients with PIVKA-II concentration in the range of 40-10000 mAU/ml took the highest rate of 59.3%. The case of PIVKA-II concentration > 100000 mAU/ml accounted for 3.5%. - AFP-L3 and PIVKA-II values ​​increased above the normal limit in the group of HCC patients with tumors < 2cm, accounting for 78.9% and 63.2%, respectively; in the group with tumor size from 2 to 5 cm were 66.7% and 93.8% and in the group with tumor size > 5cm were 84.2% and 94.7%, respectively. In the group of HCC patients with thrombosis, AFP-L3 and PIVKA-II were mainly above normal at 81.1% and 97%, respectively. - In the group of HCC patients, the ratio of AFP-L3 and AFP levels had a moderate correlation with r=0.38, p<0.05, Spearman correlation. There is no correlation between PIVKA-II levels with AFP-L3 ratio and with AFP levels in liver cancer patients, Spearman correlation. Conclusion: The combination of testing all three markers AFP-L3, PIVKA-II and AFP helps to diagnose and monitor tumor progression in HBsAg(+) hepatocellular carcinoma patients.