Influence of Alanine Transaminase Levels on Alpha-Fetoprotein for Predicting Hepatocellular Carcinoma in Patients with Hepatitis B Infection

Author:

Chen Jiahao1ORCID,Wu Manli2ORCID,Gong Jiao1ORCID,Liu Zhihuan1ORCID,He Guowei1ORCID,Zhu Huiqing3ORCID,Li Zhaoxia1ORCID,Hu Bo1ORCID

Affiliation:

1. Department of Laboratory Medicine, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

2. Department of Ultrasound, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China

3. School of Clinical Medicine, Guangdong Pharmaceutical University, Guangzhou, China

Abstract

Purpose. To investigate the influence of alanine transaminase (ALT) on the accuracy of alpha-fetoprotein (AFP) for detecting hepatocellular carcinoma (HCC).Methods. This retrospective study recruited 799 patients with HCC, cirrhosis, and chronic hepatitis due to hepatitis B infection and healthy adults between July 2017 and January 2019. Comparisons of the area under the receiver operating characteristic curves (AUCs) for detecting HCC in different ALT levels were calculated. Results. Serum ALT and gamma-glutamyl transferase levels were significantly associated with elevated AFP in patients without HCC. The AUC of AFP was higher in patients with ALT 2 upper limit of normal (ULN) than in patients with ALT > 2 ULN (0.806 vs. 0.611, P < 0.001 ). Nevertheless, there were no significant differences in the AUCs of AFP / ALT × aspartate aminotransferase AST in patients with ALT 2 ULN and with ALT > 2 ULN (0.745 vs. 0.769, P = 0.68 ). AFP / ALT × AST was better than AFP in patients with ALT > 2 ULN for detecting HCC ( P < 0.001 ). Conclusions. Higher ALT levels might impair the accuracy of AFP for diagnosing HCC. AFP tests showed better accuracy in patients with ALT 2 ULN whereas the AFP / ALT × AST ratio was recommended in patients with elevated ALT levels.

Funder

Research and Development Plan for Key Areas in Guangdong Province, China

Publisher

Hindawi Limited

Subject

General Immunology and Microbiology,General Biochemistry, Genetics and Molecular Biology,General Medicine

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