USEFULNESS OF ALPHA-FETOPROTEIN AND PIVKA-II DETECTION IN THE DIAGNOSIS OF HEPATOCELLULAR CARCINOMA IN AT-RISK POPULATION

Introduction and Objectives

Despite existing surveillance methods, the diagnosis of hepatocellular carcinoma (HCC) in at-risk populations often occurs in advanced stages of the disease and carries a worse prognosis. AFP and PIVKA-II are two of the tumor biomarkers that have received the most attention for monitoring at-risk patients.

To determine the value of the isolated and combined detection of PIVKA-II and alpha-fetoprotein in the diagnosis of hepatocellular carcinoma in at-risk population.

Materials and Methods

A cross-sectional descriptive study with an analytical component was conducted across three tertiary 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, serum alpha-fetoprotein (AFP) and PIVKA-II levels. HCC diagnosis served as the dependent variable. The ROC curve was calculated to determinate the diagnostic usefulness of the isolated AFP, PIVKA-II and the combination of both biomarkers.

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. The area under the curve was similar for AFP and PIVKA-II, confirming the good discriminatory power of both tests, but the combination of these tests was discretely greater than the biomarkers separately.

Conclusions

The diagnostic performance of both biomarkers (AFP and PIVKA-II) was similar during the evaluation of patients at risk of developing HCC, but the combination of both showed better discriminatory power between patients affected or not by this neoplasia.

Conflict of interest: None

ROC curve for alpha-fetoprotein (AFP), PIVKA-II and both biomarkers in the diagnosis of HCC in at-risk patients.