INFLUENTIAL VARIABLES FOR THE DIAGNOSIS OF HEPATOCELLULAR CARCINOMA IN HIGH-RISK PATIENTS.

Introduction and Objectives

Hepatocellular carcinoma (HCC) is a fearsome neoplasia with patients at well-identified risk who require surveillance.

To identify variables that are influential in the diagnosis of hepatocellular carcinoma in at-risk individuals.

Materials and Methods

A cross-sectional descriptive study with an analytical component was conducted across three tertiary care centers between July 2024 and April 2025. A total of 291 patients at risk for HCC were included; 11 were diagnosed with HCC. Independent variables assessed included age, sex, risk group, cirrhosis etiology, serum alpha-fetoprotein (AFP), and PIVKA-II levels. HCC diagnosis served as the dependent variable. Categorical variables were summarized as frequencies and percentages; continuous variables as means and standard deviations (SD). Univariate and multivariate logistic regression analyses were performed to identify factors significantly associated with HCC.

Results

The mean age was 62 ± 10.3 years, with a predominance of patients aged ≤62. The most common risk group was liver cirrhosis (91.1%), with a slight predominance of females. In univariate analysis, liver cirrhosis, AFP ≥ 20 ng/mL, and PIVKA-II ≥ 28.4 ng/mL were significantly associated with HCC diagnosis. Multivariate analysis showed that these same variables were statistically significantly associated with the diagnosis of hepatocellular carcinoma.

Conclusions

In at-risk patients, the presence of cirrhosis, elevated AFP (≥ 20 ng/mL) and elevated PIVKA-II (≥ 28.4 ng/mL) are strongly associated with the diagnosis of hepatocellular carcinoma.

Conflict of interest: None

	Univariate analysis				Multivariate analysis
Variables	p-value	OR not adjusted	95% C.I. for OR		p-value	Adjusted OR	95% C.I. for OR
			Lower	Superior			Lower	Superior
Age ≤ 62 y	0.894	0.960	0.524	1.757	0.512	0.755	0.325	1.751
Sex (female)	0.111	0.334	0.087	1.287	0.021	0.082	0.010	0.686
Cirrhosis	0.044	4.190	1.040	16.887	0.016	18.758	1.720	204.585
Alcohol-induced	0.786	1.336	0.166	10.775	0.996	0.993	0.050	19.837
MASLD	0.155	0.399	0.113	1.414	-	-	-	-
Chronic viral hepatitis	0.044	0.239	0.059	0.962	0.057	0.076	0.005	1.080
AFP ≥ 20 ng/L	<0.001	15.833	4.303	58.262	<0.001	34.059	4.973	233.255
PIVKA ≥ 28,4 ng/L	0.006	18.182	2.294	144.117	0.005	41.788	3.110	561.572