Objective:To explore the diagnostic value of abnormal prothrombin Ⅱ(PIVKA-Ⅱ)and alpha-fetoprotein(AFP)in primary hepatocellular carcinoma(HCC).Methods:From 2018 0.01 to 2020.01,there were 158 patients with primary liver cancer caused by chronic hepatitis B(male 116,women 42)and 62 patients with chronic hepatitis B(male 34,female 28).The levels of serum PIVKA-Ⅱ and AFP were measured,and the results were statistically analyzed.Results:The value of PIVKA-Ⅱin liver cancer group was distinctly higher than that in chronic viral hepatitis B group,the difference is statistically significant(P<0.05).So does the value of AFP.Draw the subject working characteristic curve(ROC curve),the area under the curve of AFP and PIVKA-Ⅱ is 0.799 and 0.836,and that of the combination of AFP and PIVKA-Ⅱ is 0.854,the sensitivity is 57.6%,68.4%,72.2%,respectively,the specificity is 93.5%,98.4%,96.8%,respectively.After operation or interventional therapy,the value of PIVKA-Ⅱ in liver cancer group was clearly lower than that before treatment,and the difference was statistically significant.Conclusion:In the diagnostic value of primary liver cancer,PIVKA-Ⅱ combined with AFP is higher than PIVKA-Ⅱ,while AFP has the lowest benefit.We also find that PIVKA-Ⅱ has higher disease monitoring value than AFP.