Value of combined measurement of serum growth differentiation factor 15 and alpha-fetoprotein in the diagnosis of hepatitis B virus-related hepatocellular carcinoma

Objective To investigate the clinical value of combined measurement of serum growth differentiation factor 15( GDF15) and alpha-fetoprotein( AFP) in the diagnosis of hepatocellular carcinoma( HCC) associated with hepatitis B virus( HBV) infection. Methods A total of 225 subjects who received treatment or underwent physical examination in Renmin Hospital of Wuhan University from March 1 to September 1,2019,were enrolled,among whom there were 97 patients with HCC caused by HBV infection( HCC group),41 patients with chronic hepatitis B( CHB group),and 87 healthy individuals( NC group),and the levels of GDF15 and AFP were measured for all three groups. The one-sample Kolmogorov-Smirnov test was used to determine whether the data were normally distributed or not; an analysis of variance was used for comparison of normally distributed data between multiple groups,and the least significant difference t-test was used for further comparison between two groups; the Kruskal-Wallis H test was used for comparison of non-normally distributed data between multiple groups,and the Mann-Whitney U test was used for further comparison between two groups. The chi-square test was used for comparison of categorical data. A binary logistic regression analysis was used to obtain the regression model of GDF15 and AFP; the receiver operating characteristic( ROC) curve was plotted for GDF15 and AFP used alone or in combination,and the area under the ROC curve( AUC),sensitivity,specificity,and Youden index were calculated. Results There were significant differences in the levels of GDF15 and AFP between the HCC group,the CHB group,and the NC group( χ2= 53. 77 and 119. 12,both P < 0. 01); the HCC group had a significantly higher level of GDF15 than the CHB group and the NC group( both P < 0. 01),the HCC group and the CHB group had a significantly higher level of AFP than the NC group,and the HCC group had a significantly higher level of AFP than the CHB group( all P < 0. 01). The ROC curve analysis showed that GDF15 alone had an AUC of 0. 752,a sensitivity of 74. 0%,and a specificity of 68. 3%,AFP alone had an AUC of 0. 660,a sensitivity of 45. 8%,and a specificity of 85. 4%,and GDF15 combined with AFP had an AUC of 0. 816,a sensitivity of 88. 4%,and a specificity of 68. 5%. Conclusion Combined measurement of GDF15 and AFP can improve the diagnostic efficiency for HBV-related HCC and has a high clinical value.