Alpha-Fetoprotein+Alkaline Phosphatase (A-A) Score Can Predict the Prognosis of Patients with Ruptured Hepatocellular Carcinoma Underwent Hepatectomy

Xia, Feng; Ndhlovu, Elijah; Liu, Zhicheng; Chen, Xiaoping; Zhang, Bixiang; Zhu, Peng

doi:10.1155/2022/9934189

Cited by 4 publications

(1 citation statement)

References 29 publications

(35 reference statements)

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“…Several serum biomarkers have been shown to assist in the diagnosis and prognosis of HCC, including liver enzyme indicators (aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALKP), and γ-glutamyl transpeptidase (GGT)), or indicators reflecting liver metabolism (total bilirubin (TBIL)) and protein synthesis function (total protein (TP), albumin (ALB), and prothrombin time (PT)) [ 25 , 26 , 27 , 28 , 29 , 30 ]. To fully explore and harness the potential benefits of different biomarkers, it is necessary to identify potential serum/plasma protein biomarkers that can be combined with AFP and PIVKA-II to facilitate HCC detection and surveillance.…”

Section: Introductionmentioning

confidence: 99%

Diagnostic and Prognostic Nomograms for Hepatocellular Carcinoma Based on PIVKA-II and Serum Biomarkers

Zhan

Liu

et al. 2023

Diagnostics

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Background: The aim of the present study was to develop an improved diagnostic and prognostic model for HBV-associated HCC by combining AFP with PIVKA-II and other potential serum/plasma protein biomarkers. Methods: A total of 578 patients, including 352 patients with HBV-related HCC, 102 patients with HBV-associated liver cirrhosis (LC), 124 patients with chronic HBV, and 127 healthy subjects (HS), were enrolled in the study. The serum levels of AFP, PIVKA-II, and other laboratory parameters were collected. Univariate and multivariate logistic regression and Cox regression analyses were performed to identify independent diagnostic and prognostic factors, respectively. The diagnostic efficacy of the nomogram was evaluated using receiver operator curve (ROC) analysis and the prognostic performance was measured by Harrell’s concordance index (C-index). Results: AFP and PIVKA-II levels were significantly increased in HBV-related HCC, compared with those in HBV-associated LC and chronic HBV participants (p < 0.05 and p < 0.001, respectively). The diagnostic nomogram, which included age, gender, AFP, PIVKA-II, prothrombin time (PT), and total protein (TP), discriminated patients with HBV-HCC from those with HBV-LC or chronic HBV with an AUC of 0.970. In addition, based on the univariate and multivariate Cox regression analysis, PIVKA-II, γ-glutamyl transpeptidase, and albumin were found to be significantly associated with the prognosis of HBV-related HCC and were incorporated into a nomogram. The C-index of the nomogram for predicting 3-year survival in the training and validation groups was 0.75 and 0.78, respectively. The calibration curves for the probability of 3-year OS showed good agreement between the nomogram prediction and the actual observation in the training and the validation groups. Furthermore, the nomogram had a higher C-index (0.74) than that of the Child−Pugh grade (0.62), the albumin−bilirubin (ALBI) score (0.64), and Barcelona Clinic Liver Cancer (0.56) in all follow-up cases. Conclusion: Our study suggests that the nomograms based on AFP, PIVKA-II, and potential serum protein biomarkers showed a better performance in the diagnosis and prognosis of HCC, which may help to guide therapeutic strategies and assess the prognosis of HCC.

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