Evaluating the diagnostic efficacy of a 4-marker serum panel for hepatitis B virus-related hepatocellular carcinoma.

[INTRODUCTION] We sought to investigate the diagnostic efficacy of protein induced by vitamin K absence or antagonist II combined with ɑ-fetoprotein, aspartate aminotransferase/alanine aminotransferase ratio, and γ-glutamyltransferase and to provide a more reliable combined detection scheme for the clinical diagnosis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC).

[METHODS] The research used a retrospective case-control framework encompassing 300 participants who were allocated to 1 of 4 groups. Clinical data and serum biomarker levels were collected. A multivariable logistic regression model was developed to integrate these markers into a quantitative risk score. The diagnostic performance of all models was evaluated using receiver operating characteristic curve analysis, with areas under the curve (AUCs) compared using the DeLong test. Optimal diagnostic thresholds were determined based on prespecified high-sensitivity targets to align with clinical screening and surveillance goals.

[RESULTS] For broad screening (HBV-related HCC vs control), the combined model achieved a superior AUC of 0.906; at 90% sensitivity, its specificity was 70.7%. For high-risk surveillance (HBV-related HCC vs benign liver disease), the model achieved an AUC of 0.837; at 80% sensitivity, its specificity was 74.6%, representing a clinically optimal balance.

[DISCUSSION] The multimarker combined detection strategy substantially improves diagnostic efficacy for HBV-related HCC compared with single-marker approaches.