Abstract: Objective The aim of this study was to investigate diagnostic performance of ultrasound features in combination with serum reactive oxygen species modulator 1 (ROMO1)and alpha-fetoprotein (AFP) levels in children with hepatoblastoma (HB). Methods 112 children with focal liver lesions (FLL) were encountered in our hospital between January 2022 and January 2025, and they all received ultrasonography. Serum ROMO1 level was detected by ELISA, and serum AFP level was detected by chemiluminescence. Receiver operating characteristic (ROC) curve was applied to evaluate diagnostic efficacy. Results Of the 112 children with FLL, the histo-pathological examination found HB in 78 cases and benign lesions in 34 cases; diameter of tumors, percentages of irregular lesion and local infiltration in children with HB were(9.2±2.3)cm, 51.3% and 35.9%, all significantly greater or higher than [(1.6±0.6)cm, 10.3% and 0.0%, respectively, P<0.05] in benign lesions; serum AFP and ROMO1 levels in patients with HB were (156.4±24.5)ng/mL and (130.1±20.1)ng/mL, both significantly higher than [(7.1±2.4)ng/mL and (19.0±3.7)ng/mL, respectively, P<0.05] in those with benign lesions; ROC analysis showed that the AUC was 0.867, with sensitivity of 96.2% and specificity of 64.7%, when ultrasonic features in combination with serum AFP and ROMO1 levels in diagnosing HB in children. Conclusion Ultrasound features in combination with serum ROMO1 and AFP levels could provide a more reliable auxiliary tool for early accurate identification of HB in children.

Key words: Hepatoblastoma, Ultrasonography, Reactive oxygen species modulator 1, Alpha-fetoprotein, Diagnosis, Children