Objectives: Our study aims to detect the sensitivity of the new biomarker miR-212 existing in serum
exosomes along with other hepatocellular carcinoma biomarkers such as AFP (alpha-fetoprotein), CA125 (carbohydrate
antigen-ca125), and Hbx protein in the diagnosis of HBV-related liver diseases. We also aim to study the roles
of these biomarkers in the progression of chronic hepatitis B and provide scientific data to show the clinical value of
Methods: We selected 200 patients with HBV-infection (58 cases of chronic hepatitis B, 47 cases of hepatocellular
carcinoma, 30 cases of compensatory phase cirrhosis, and 65 cases of decompensatory phase cirrhosis), 31 patients
with primary liver cancer without HBV infection, and 70 healthy individuals as the control group. The expression
level of serum AFP and CA125 was detected with electrochemiluminescence immunoassay. The expression level of
the Hbx protein was detected with ELISA. Meanwhile, the expression level of miR-212 in serum was analyzed with
RT-qPCR. We collected patients’ clinical information following the Child-Pugh classification and MELD score
criterion, and statistical analysis was made between the expression level of miR-212 and the collected clinical indexes.
Lastly, we predicted the target genes of the miR-212 and its functions using bioinformatics methods such as
cluster analysis and survival prediction.
Results: Compared to the control group, the expression level of miR-212 in HBV infected patients was remarkably
increased (P<0.05), especially between the HBV-infection Hepatocellular carcinoma group and the non-HBVinfection
liver cancer group (P<0.05). The expression of miR-212 was increased in patients’ Child-Pugh classification,
MELD score, and TNM staging. Moreover, the sensitivity and specificity of miR-212 were superior to AFP,
CA125, and HBx protein.
Conclusion: There is a linear relationship between disease progression and expression level of miR-212 in the serum
of HBV infected patients. This demonstrates that miR-212 plays a significant role in liver diseases. miR-212 is expected
to be a new biomarker used for the diagnosis and assessment of patients with HBV-infection-related liver