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

Abstract

Background: One indicator indicative of the existence of a systemic inflammatory response that may be easily and cheaply established by standard blood testing is the neutrophil-to-lymphocyte ratio (NLR). The goal of this investigation was to evaluate the usefulness of NLR in conjunction with alpha fetoprotein (AFP)or to detect hepatocellular carcinoma (HCC). Methods: This cross-sectional study involved the examination of 100 patients who were categorized into two distinct group. The first group, referred to as group A, consisted of patients who had recently been diagnosed with HCC based on positive dynamic computed tomography (CT) scans. The characteristic property of HCC during CT scans is the existence of arterial enhancement, followed by the tumor's washout in the portal-venous and/or delayed phases. The second group, referred to as group B, comprised 50 control patients who had chronic liver disease, primarily resulting from hepatitis C or hepatitis B virus (HBV) infection, as well as patients with cirrhosis and hepatitis. Results: A notable and statistically significant reduction in the levels of lymphocytes and neutrophils was seen in participants with HCC as compared to the control group. A noteworthy negative association was seen between NLR and neutrophil count, alpha-fetoprotein (AFP), alanine aminotransferase (ALT) and lymphocyte count. On the other hand, a substantial positive correlation was found aspartate aminotransferase (AST) and the NLR. The combined use of AFP and NLR has shown the ability to identify individuals with HCC with enhanced levels of sensitivity and specificity, achieving 92% and 88% respectively. Conclusions: Together, AFP and NLR were more effective than each marker alone in distinguishing between liver disease and HCC.