Purpose: The purpose of this study was to evaluate the diagnostic value of soluble Axl (sAxl) in hepatocellular carcinoma (HCC) in comparison with serum α-fetoprotein (AFP). Materials and Methods: Eighty HCC patients, 80 liver cirrhosis patients (LC), 80 patients with hepatitis B virus (HBV) infection, and 80 healthy controls (HC) were enrolled. sAxl levels were measured by an enzyme-linked immunosorbent assay, serum AFP levelswere measured by an electrochemiluminescence immunoassay. Receiver operating characteristic (ROC) curves were used to evaluate diagnostic performances. Results: The results show that levels of sAxl were high expression in patients with HCC (p < 0.05), varied with disease state as follows: HCC > LC > HC > HBV. Logistic regression and ROC curve analysis identified the optimal cut-off for sAxl in differentiating all HCC and non-HCC patients was 1,202 pg/mL (area under the receiver operating characteristic [AUC], 0.888; 95% confidence interval [CI], 0.852 to 0.924) with sensitivity 95.0%, specificity 73.3%. Furthermore, differential diagnosis of early HCC with non-HCC patients for sAxl showed the optimal cut-off was 1,202 pg/mL (AUC, 0.881; 95% CI, 0.831 to 0.931; sensitivity, 94.1%; specificity, 73.3%). Among AFP-negative HCC patients with non-HCC patients, the cut-off was 1,301 pg/mL (AUC, 0.898; 95% CI, 0.854 to 0.942) with a sensitivity of 84.6%, a specificity of 76.3%. The optimal cut-off for sAxl in differentiating all HCC and chronic liver disease patients was 1,243 pg/mL (AUC, 0.840; 95% CI, 0.791 to 0.888) with sensitivity 93.8%, specificity 61.9%. The combination of AFP and sAxl increased diagnostic value for HCC. Conclusion sAxl outperforms AFP in detecting HCC, especially in early HCC and in AFP-negative HCC. Combination sAxl with AFP improved the specificity for early HCC diagnosis. In summary, sAxl is a candidate serum marker for diagnosing HCC.

Objective To explore the diagnostic value of serum levels of fibroblast growth factor 22(FGF22)and CXC chemokine ligand 16(CXCL16)in patients with Parkinson's disease(PD)in cognitive impairment.Methods A total of 125 PD patients admitted to Handan Traditional Chinese Medicine Hospital from June 2022 to June 2023 were selected as the research subjects,and they were separated into a non cognitive impairment group(n=38)and a cognitive impairment group(n=87)based on whether they had cognitive impairment.Enzyme-linked immunosorbent assay(ELISA)was applied to determine the levels of serum FGF22 and CXCL16 in each group.Spearman correlation was applied to analyze the correlation among serum FGF22 and CXCL16 expression levels,Unified Parkinson's Disease Rating Scale(UPDRS)and Montreal Cognitive Assessment(MoCA)scores.Multivariate logistic regression was applied to analyze the factors affecting cognitive impairment in PD patients.Receiver operating characteristic(ROC)curve was applied to analyze the diagnostic efficacy of FGF22 and CXCL16 for cognitive impairment in PD patients.Results Compared with the non cognitive impairment group,the expression level of serum FGF22(184.16±14.62ng/ml vs 203.24±12.15ng/ml)in cognitive impairment group and the MoCA score(23.91±3.14 分 vs 26.54±2.31 分)were decreased(t=7.048,4.460,all P＜0.05),while the expression levels of CXCL16(2.59±0.46ng/ml vs 2.06±0.34ng/ml)and the UPDRS score(41.43±5.62 score vs 32.46±4.28 score)were increased(t=6.376,8.782,all P＜0.05),and the differences were statisaically significant.According to Spearman correlation analysis,the expression level of serum FGF22 was negatively correlated with UPDRS score(r=-0.435,P＜0.05),but positively correlated with MoCA score(r=0.742,P＜0.05).The expression level of CXCL16 in serum was positively correlated with UPDRS score(r=0.532,P＜0.05),but negatively correlated with MoCA score(r=-0.623,P＜0.05).Multivariate logistic analysis showed that FGF22 and MoCA scores were protective factors for cognitive impairment in PD patients(all P＜0.05),while CXCL16 and UPDRS scores were risk factors for cognitive impairment in PD patients(all P＜0.05).The combination of serum FGF22 and CXCL16 in the diagnosis of cognitive impairment in PD patients had better AUC than their respective alone diagnoses(Z=2.919,2.437,P=0.003,0.015),with a sensitivity and a specificity of 93.10％and 73.68％,respectively.Conclusion The levels of serum FGF22 and CXCL16 were closely related to cognitive impairment in PD patients,and the combination of the two could better diagnose whether PD patients have cognitive impairment.