Evidence map›Paper›PMID 30545306›Full record

ArticleBMC gastroenterology2018

Diagnostic value of alpha-fetoprotein combined with neutrophil-to-lymphocyte ratio for hepatocellular carcinoma.

Jian Hu, Nianyue Wang, Yongfeng Yang, Li Ma, Ruilin Han, Wei Zhang, Cunling Yan, Yijie Zheng, Xiaoqin Wang

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC gastroenterology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
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  7. Medicinal chemistry (Shariqah (United Arab Emirates)) · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Jian HuDepartment of Clinical Laboratory, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, People's Republic of China.
Nianyue WangDepartment of Clinical Laboratory and Liver Diseases, The Second Hospital of Nanjing, Affiliated to Medical School of Southeast University, Nanjing, 210000, China.
Yongfeng YangDepartment of Clinical Laboratory and Liver Diseases, The Second Hospital of Nanjing, Affiliated to Medical School of Southeast University, Nanjing, 210000, China.
Li MaDepartment of Clinical Laboratory and Liver Diseases, The Second Hospital of Nanjing, Affiliated to Medical School of Southeast University, Nanjing, 210000, China.
Ruilin HanDepartment of Clinical Laboratory, Peking University First Hospital, Beijing, 100000, China.
Wei ZhangDepartment of Mathematics & Statistics, University of Arkansas at Little Rock, Little Rock, AR, 72204, USA.
Cunling YanDepartment of Clinical Laboratory, Peking University First Hospital, Beijing, 100000, China. yancunling@163.com.
Yijie ZhengMedical Scientific Affairs, Abbott Diagnostics Division, Abbott Laboratories, Shanghai, 200032, China. yijiezheng2015@163.com.
Xiaoqin WangDepartment of Clinical Laboratory, The First Affiliated Hospital of Xi'an Jiaotong University, 277 West Yanta Road, Xi'an, 710061, People's Republic of China. 1493722680@qq.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTo investigate the diagnostic performance of alpha-fetoprotein (AFP) and neutrophil-to-lymphocyte ratio (NLR) as well as their combinations with other markers.

methodsSerum 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.

resultsIn 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.

conclusionsOur 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.

Indexed as

LymphocytesNeutrophilsAdultAlanine Transaminasealpha-FetoproteinsAspartate AminotransferasesBiomarkersCarcinoma, HepatocellularDiagnosis, DifferentialFemaleHumansLeukocyte CountLiver DiseasesLiver NeoplasmsMaleMiddle AgedAFP protein, humanAlanine Transaminasealpha-FetoproteinsAspartate AminotransferasesBiomarkersAlpha-fetoproteinHepatocellular carcinomaNeutrophil-granulocyte ratio

Identifiers

PMID30545306
PMCPMC6293657

What OpenQuestion holds

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LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.