Optimizing early screening for hepatocellular carcinoma: Diagnostic value of ultrasonography combined with serum biomarkers.

This study assesses the diagnostic performance of ultrasonography combined with serum biomarkers (alpha-fetoprotein [AFP], serum amyloid A [SAA], and C-reactive protein [CRP]) for early detection of hepatocellular carcinoma (HCC) in high-risk individuals, and to evaluate diagnostic agreement using the kappa coefficient to inform optimized screening strategies. A retrospective cohort of 100 high-risk patients screened for HCC between January 2022 and December 2023 was analyzed. Patients were assigned to an experimental group (n = 50; ultrasound + AFP, SAA, CRP) or a control group (n = 50; AFP, SAA, CRP only). Diagnostic performance was evaluated by detection rate, sensitivity, specificity, positive predictive value, negative predictive value, and agreement with contrast-enhanced CT and pathology, using the kappa coefficient (κ). The experimental group exhibited significantly higher detection rate (76.0% vs 50.0%, P = .01), sensitivity (88.4% vs 64.1%, P = .01), specificity (92.0% vs 78.0%, P = .04), positive predictive value (95.0% vs 78.1%, P = .02), and negative predictive value (82.1% vs 64.0%, P = .03). The kappa coefficient indicated good diagnostic agreement in the experimental group (κ = 0.81) and moderate agreement in the control group (κ = 0.56). Ultrasonography combined with AFP, SAA, and CRP significantly improves early HCC detection and diagnostic consistency and may serve as a routine screening tool in high-risk populations. Integration with artificial intelligence and elastography may further enhance screening accuracy.