The Index sAGP is Valuable for Distinguishing Atypical Hepatocellular Carcinoma from Atypical Benign Focal Hepatic
Qing-Qing Luo1, Qiao-Nan Li1, Dan Cai1
1Department of Gastroenterology, the First Affiliated Hospital of Nanchang University, Jiangxi Institute of Gastroenterology & Hepatology, Nanchang, People's Republic of China.
Journal of Hepatocellular Carcinoma
|February 13, 2024
Summary
A new blood test index, sAGP, effectively differentiates atypical hepatocellular carcinoma (aHCC) from atypical benign focal hepatic lesions (aBFHL) without invasive procedures. This offers a practical, non-invasive diagnostic tool for liver lesions.
Area of Science:
- Hepatology
- Oncology
- Biochemistry
Background:
- Distinguishing atypical hepatocellular carcinoma (aHCC) from atypical benign focal hepatic lesions (aBFHL) often requires invasive pathological examination.
- Developing non-invasive diagnostic methods is crucial for improving patient management and reducing healthcare burdens.
Purpose of the Study:
- To develop and validate non-invasive approaches using conventional blood indicators for the differential diagnosis of aHCC and aBFHL.
- To identify novel blood-based biomarkers that can accurately differentiate between malignant and benign liver lesions.
Main Methods:
- Retrospective analysis of clinical data from hospitalized patients with pathologically confirmed focal hepatic lesions.
- Development and evaluation of derived blood indexes using mathematical operations on conventional indicators like alpha-fetoprotein (AFP), gamma-glutamyltransferase (GGT), and platelet (PLT) counts.
- Utilizing receiver operating characteristic (ROC) curve analysis to assess the diagnostic performance of the indexes.
Main Results:
- The GPR index (GGT/PLT ratio) showed moderate performance (AUROC = 0.853).
- A newly developed index, sAGP [(standardized AFP + standardized GGT)/standardized PLT], demonstrated superior diagnostic accuracy with AUROCs ranging from 0.862 to 0.925 across different patient subgroups.
- The sAGP index proved effective in differentiating overall aHCC from aBFHL, as well as specific subgroups including BCLC stage 0/A, TNM stage I, small lesions, and AFP-negative cases.
Conclusions:
- The sAGP index is a highly efficient, simple, and practical metric for the non-invasive differentiation of aHCC from aBFHL.
- This novel blood-based index offers a promising alternative to invasive diagnostic procedures.
- The sAGP index has the potential to significantly improve the diagnostic workflow for patients with atypical focal hepatic lesions.
