Albumin-to-alkaline phosphatase ratio: a novel prognostic index for hepatocellular carcinoma

Disease Markers
Anthony W H ChanKa-Fai To

Abstract

Prognosis of patients with hepatocellular carcinoma (HCC) depends on both tumour extent and hepatic function reserve. Liver function test (LFT) is a basic routine blood test to evaluate hepatic function. We first analysed LFT components and their associated scores in a training cohort of 217 patients who underwent curative surgery to identify LFT parameters with high performance (discriminatory capacity, homogeneity, and monotonicity of gradient). We derived a novel index, albumin-to-alkaline phosphatase ratio (AAPR), which had the highest c-index (0.646) and χ(2) (24.774) among other liver biochemical parameters. The AAPR was an independent prognostic factor for overall and disease-free survival. The adjusted hazard ratio of death and tumour relapse was 2.36 (P = 0.002) and 1.85 (P = 0.010), respectively. The independent prognostic significance of AAPR on top of 5 commonly used and well established staging systems was further confirmed in 2 independent cohorts of patients receiving surgical resection (n = 256) and palliative therapy (n = 425). In summary, the AAPR is a novel index readily derived from a simple low-cost routine blood test and is an independent prognostic indicator for patients with HCC regardless of treatment o...Continue Reading

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Citations

Jan 12, 2016·Journal of Gastroenterology and Hepatology·Anthony W H ChanStephen L Chan
Oct 30, 2016·Journal of Gastroenterology and Hepatology·Anthony W H ChanStephen L Chan
Jun 4, 2016·Journal of Gastroenterology and Hepatology·Anthony W H ChanStephen L Chan
Jan 29, 2016·Biomarker Insights·Jennifer LoutenGabrielle Holenstein
Oct 2, 2019·Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery·Huifen YangHuifang Zhou
Jun 22, 2017·Journal of Gastrointestinal Cancer·Necati Örmeci
Jan 6, 2021·International Journal of Hyperthermia : the Official Journal of European Society for Hyperthermic Oncology, North American Hyperthermia Group·Feng ZhangXin Yin
Dec 31, 2020·BioMed Research International·Hailun XieJialiang Gan
Mar 2, 2021·Journal of Vascular and Interventional Radiology : JVIR·Alexander VillalobosNima Kokabi
Apr 15, 2021·Zeitschrift für Rheumatologie·P KarakostasV S Schäfer
May 14, 2020·Liver Cancer·Stephen Lam ChanAnthony Wing-Hung Chan

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Methods Mentioned

BETA
surgical resection
CLIP

Software Mentioned

R
R Foundation for Statistical Computing

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