Diagnostic value of alpha-fetoprotein combined with neutrophil-to-lymphocyte ratio for hepatocellular carcinoma
Abstract Background To investigate the diagnostic performance of alpha-fetoprotein (AFP) and neutrophil-to-lymphocyte ratio (NLR) as well as their combinations with other markers. Methods Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), AFP and levels as well as the numbers of...
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| Format: | Article |
| Language: | English |
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BMC
2018-12-01
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| Series: | BMC Gastroenterology |
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| Online Access: | http://link.springer.com/article/10.1186/s12876-018-0908-6 |
| _version_ | 1818283888286367744 |
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| author | Jian Hu Nianyue Wang Yongfeng Yang Li Ma Ruilin Han Wei Zhang Cunling Yan Yijie Zheng Xiaoqin Wang |
| author_facet | Jian Hu Nianyue Wang Yongfeng Yang Li Ma Ruilin Han Wei Zhang Cunling Yan Yijie Zheng Xiaoqin Wang |
| author_sort | Jian Hu |
| collection | DOAJ |
| description | Abstract Background To investigate the diagnostic performance of alpha-fetoprotein (AFP) and neutrophil-to-lymphocyte ratio (NLR) as well as their combinations with other markers. Methods Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), AFP and levels as well as the numbers of neutrophils and lymphocytes of all enrolled patients were collected. The NLR was calculated by dividing the number of neutrophils by the number of lymphocytes. Receiver operating characteristic (ROC) curve analysis was conducted to determine the ability of each marker and combination of markers to distinguish HCC and liver disease patients. Results In total, 545 patients were included in this study. The area under the ROC curve (AUC) values for AFP, ALT, AST, and NLR were 0.775 (0.738–0.810), 0.504 (0.461–0.547), 0.660 (0.618–0.699), and 0.738 (0.699–0.774) with optimal cut-off values of 24.6 ng/mL, 111 IU/mL, 27 IU/mL, and 2.979, respectively. Of the four biomarkers, AFP and NLR showed comparable specificity (0.881 and 0.858) and sensitivity (0.561 and 0.539). The combination of AFP and NLR showed the highest AUC (0.769) with a significantly higher sensitivity (0.767) and a lower specificity (0.773) compared to AFP or NLR alone, and it had the highest sum of sensitivity and specificity (1.54) among all combinations. In patients with AFP < 20 ng/mL, the NLR showed the highest AUC and combination with other markers did not improve the diagnostic accuracy. Conclusions Our data indicate that the combination of AFP and NLR offers better diagnostic performance than either marker alone for differentiating HCC from liver disease, which may benefit clinical screening. |
| first_indexed | 2024-12-13T00:44:04Z |
| format | Article |
| id | doaj.art-447f541d069e4dfea5d09f84746bca6f |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-12-13T00:44:04Z |
| publishDate | 2018-12-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-447f541d069e4dfea5d09f84746bca6f2022-12-22T00:05:05ZengBMCBMC Gastroenterology1471-230X2018-12-011811710.1186/s12876-018-0908-6Diagnostic value of alpha-fetoprotein combined with neutrophil-to-lymphocyte ratio for hepatocellular carcinomaJian Hu0Nianyue Wang1Yongfeng Yang2Li Ma3Ruilin Han4Wei Zhang5Cunling Yan6Yijie Zheng7Xiaoqin Wang8Department of Clinical Laboratory, The First Affiliated Hospital of Xi’an Jiaotong UniversityDepartment of Clinical Laboratory and Liver Diseases, The Second Hospital of Nanjing, Affiliated to Medical School of Southeast UniversityDepartment of Clinical Laboratory and Liver Diseases, The Second Hospital of Nanjing, Affiliated to Medical School of Southeast UniversityDepartment of Clinical Laboratory and Liver Diseases, The Second Hospital of Nanjing, Affiliated to Medical School of Southeast UniversityDepartment of Clinical Laboratory, Peking University First HospitalDepartment of Mathematics & Statistics, University of Arkansas at Little RockDepartment of Clinical Laboratory, Peking University First HospitalMedical Scientific Affairs, Abbott Diagnostics Division, Abbott LaboratoriesDepartment of Clinical Laboratory, The First Affiliated Hospital of Xi’an Jiaotong UniversityAbstract Background To investigate the diagnostic performance of alpha-fetoprotein (AFP) and neutrophil-to-lymphocyte ratio (NLR) as well as their combinations with other markers. Methods Serum aspartate aminotransferase (AST), alanine aminotransferase (ALT), AFP and levels as well as the numbers of neutrophils and lymphocytes of all enrolled patients were collected. The NLR was calculated by dividing the number of neutrophils by the number of lymphocytes. Receiver operating characteristic (ROC) curve analysis was conducted to determine the ability of each marker and combination of markers to distinguish HCC and liver disease patients. Results In total, 545 patients were included in this study. The area under the ROC curve (AUC) values for AFP, ALT, AST, and NLR were 0.775 (0.738–0.810), 0.504 (0.461–0.547), 0.660 (0.618–0.699), and 0.738 (0.699–0.774) with optimal cut-off values of 24.6 ng/mL, 111 IU/mL, 27 IU/mL, and 2.979, respectively. Of the four biomarkers, AFP and NLR showed comparable specificity (0.881 and 0.858) and sensitivity (0.561 and 0.539). The combination of AFP and NLR showed the highest AUC (0.769) with a significantly higher sensitivity (0.767) and a lower specificity (0.773) compared to AFP or NLR alone, and it had the highest sum of sensitivity and specificity (1.54) among all combinations. In patients with AFP < 20 ng/mL, the NLR showed the highest AUC and combination with other markers did not improve the diagnostic accuracy. Conclusions Our data indicate that the combination of AFP and NLR offers better diagnostic performance than either marker alone for differentiating HCC from liver disease, which may benefit clinical screening.http://link.springer.com/article/10.1186/s12876-018-0908-6Alpha-fetoproteinNeutrophil-granulocyte ratioHepatocellular carcinoma |
| spellingShingle | Jian Hu Nianyue Wang Yongfeng Yang Li Ma Ruilin Han Wei Zhang Cunling Yan Yijie Zheng Xiaoqin Wang Diagnostic value of alpha-fetoprotein combined with neutrophil-to-lymphocyte ratio for hepatocellular carcinoma BMC Gastroenterology Alpha-fetoprotein Neutrophil-granulocyte ratio Hepatocellular carcinoma |
| title | Diagnostic value of alpha-fetoprotein combined with neutrophil-to-lymphocyte ratio for hepatocellular carcinoma |
| title_full | Diagnostic value of alpha-fetoprotein combined with neutrophil-to-lymphocyte ratio for hepatocellular carcinoma |
| title_fullStr | Diagnostic value of alpha-fetoprotein combined with neutrophil-to-lymphocyte ratio for hepatocellular carcinoma |
| title_full_unstemmed | Diagnostic value of alpha-fetoprotein combined with neutrophil-to-lymphocyte ratio for hepatocellular carcinoma |
| title_short | Diagnostic value of alpha-fetoprotein combined with neutrophil-to-lymphocyte ratio for hepatocellular carcinoma |
| title_sort | diagnostic value of alpha fetoprotein combined with neutrophil to lymphocyte ratio for hepatocellular carcinoma |
| topic | Alpha-fetoprotein Neutrophil-granulocyte ratio Hepatocellular carcinoma |
| url | http://link.springer.com/article/10.1186/s12876-018-0908-6 |
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