Hepatocellular carcinoma (HCC) is a malignant tumor of the liver which accounts for up to 90% of all liver cancers. In recent years, there has been an increase in the incidence of HCC all over the world, including in Kazakhstan. Diagnostic issues are still important. Alpha-fetoprotein (AFP) is a specific marker most widely used in the diagnosis of HCC. The article describes of the features of the AFP expression level in immunohistochemical studies with different stages and gradation of hepatocellular carcinoma, as well as a correlation analysis with serum AFP. Material and methods. A total of 50 patients with HCC were analyzed. Blood serum tests were performed to determine the level of AFP and an IHC study to assess the expression of AFP. Results. When analyzing the serological AFP, it was found that in the vast majority of cases (n=33), values were between 10-20 units/ml. In 83% cases HCC, cytoplasmic and nuclear expression of AFP was determined in malignant cells in IHC. The expression of the AFP was high in 32% cases, moderate in 46% cases, and low or not detected in 22% cases. The area of AFP - immunopositive cells node averaged 37.25±15.47%. When conducting a correlation analysis, it was found that the overall Pearson correlation coefficient between serum AFP and the degree of AFP staining was r = +0.0089. Conclusion. Critically high AFP values correlate with the degree of HCC differentiation. The results of IHC showed that in 83% of patients with HCC, cytoplasmic and nuclear expression of AFP, which indicates a high sensitivity of the marker regarding the definition of malignancy. Given the absence of a correlation, it can be assumed that the serum AFP value cannot be associated with AFP expression data in immunohistochemistry and can be used as a separate value for HCC differentiation

Background/Objectives: Autoimmune hepatitis (AIH) is a chronic immune-mediated liver disease that may progress to cirrhosis and liver failure if not diagnosed early. Although liver biopsy remains the reference standard for fibrosis assessment, its invasive nature limits routine use. This study aimed to compare the diagnostic performance of ultrasound-based microvascular imaging (MVI), transient elastography (TE), and serum fibrosis indices (APRI and FIB-4) in patients with biopsy-confirmed AIH. Methods: Fifty-five patients with probable or definite AIH according to IAIHG criteria were included in the study. All patients underwent liver biopsy, and fibrosis stage was assessed using the METAVIR system. TE and MVI examinations were performed, and APRI and FIB-4 scores were calculated. Diagnostic performance was evaluated using AUROC, sensitivity, and specificity. Spearman correlation and logistic regression analyses were additionally performed. Results: The mean age of the patients was 49.2 years, and most patients were women. Cirrhosis was present in 58.2% of the cohort. TE demonstrated high diagnostic accuracy, whereas FIB-4 showed moderate performance and APRI demonstrated limited utility. MVI achieved the highest diagnostic performance, with AUROC values of 0.99 for significant fibrosis and 0.97 for cirrhosis. MVI showed the strongest correlation with histological fibrosis stage (r = 0.916, p < 0.001), followed by TE (r = 0.907, p < 0.001). MVI was strongly associated with histologically confirmed cirrhosis (OR 16.7, 95% CI 2.36–118.2, p = 0.004). Conclusions: MVI demonstrates diagnostic performance comparable to TE and may represent a promising adjunctive non-invasive imaging biomarker for fibrosis assessment in AIH. Larger multicenter studies are required for external validation before routine clinical implementation.