Abstract: Objective The purpose of this study was to investigate the diagnostic performance of serum serine protease inhibitor Kazal type 1 (SPINK1) levels for hepatocellular carcinoma (HCC) in patients with hepatitis B-induced liver cirrhosis (LC). Methods A total of 204 consecutive patients with hepatitis B-induced LC were encountered in our hospital between April 2020 and April 2023, andall underwent dynamic contrast-enhanced magnetic resonance imaging (MRI). The patients who had intrahepatic space-occupying lesions received fine needle aspiration biopsies (FNAB) for histo-pathological examination. Serum SPTINK1 and alpha-fetoprotein (AFP) levels were detected by ELISA. The multivariate Logistic regression analysis and receiver-operating characteristic curve (ROC) were applied to predict the diagnostic efficacy. Results Out the 204 patients with hepatitis B-induced LC, the intrahepatic space-occupying lesions were found in 30 cases(14.7%)by MRI, and the histo-pathological examination showed all with HCC; serum SPTINK1 and AFP levels in patients with HCC were (23.9±5.2)ng/mL and (426.5±67.0)ng/mL, both significantly higher than [(7.4±2.1)ng/mL and (14.4±4.3)ng/mL, respectively, P＜0.05] in those with LC; both serum SPTINK1(OR:3.69, 95%CI:1.08-12.49) and AFP (OR:3.54, 95%CI:1.04-11.98) were positively correlated to HCC existence; the AUC was 0.80(95%CI:0.72-0.89), with the sensitivity (Se) of 71% and the specificity (Sp) of 73%, when serum AFP level equal to or greater than 360.1 ng/mL was set as the cut-off-value, and the AUC was 0.82(95%CI:0.74-0.91), with the Se of 82% and the Sp of 79%, when serum SPTINK1 level equal to or greater than 15.6 ng/mL was set as the cut-off-value in diagnosing HCC. Conclusion The elevated serum SPINK1 and AFP levels might hint the malignant tumor in LC patients with MRI-proven space-occupying lesions, and the FNAB could determine the diagnosis.

Key words: Hepatoma, Liver cirrhosis, Enhanced magnetic resonance, Protease inhibitor Kazal type 1, Alpha-fetoprotein, Diagnosis