Monocyte to apolipoprotein A1 ratio as a novel biomarker for hepatocellular carcinoma: a retrospective study
Cheng Su1, Xuefeng Zhu2, Jiao Lan1
1Scientific Research and Experimental Center, The People's Hospital of Guangxi Zhuang Autonomous Region, Guangxi Academy of Medical Sciences, Nanning, China.
Background:
The ratio of monocyte to apolipoprotein A1 (MAR) has emerged as a potential diagnostic marker for various chronic conditions, yet its utility in hepatocellular carcinoma (HCC) remains unexplored. This retrospective study aimed to evaluate the MAR's predictive capacity in HCC diagnosis and differentiation from hepatitis B virus (HBV) infection.
Methods:
A total of 1,350 participants were enrolled, including 270 HCC patients, 540 HBV patients, and 540 healthy controls. Hematological parameters including monocyte counts and apolipoprotein A1 levels were retrospectively collected from electronic medical records. Receiver operating characteristic (ROC) curve analysis was performed to determine optimal cut-off values and area under the curve (AUC). Multivariate logistic regression was used to identify independent predictor of HCC. Correlation analysis was conducted to explore associations between MAR and other clinical parameters.
Results:
MAR level was the highest in the HCC, followed by HBV group, and the lowest in the healthy controls (P<0.001). ROC analysis revealed MAR's discriminative capacity (AUC =0.829 for HCC vs. controls; AUC =0.762 for HCC vs. HBV). Multivariate analysis identified MAR as an independent HCC predictor [odds ratio (OR) =6.001, P<0.001]. Significant correlations emerged between MAR and lymphocytes (r=-0.075, P<0.05), carcinoembryonic antigen (r=0.171, P<0.001), and albumin (r=-0.445, P<0.001).
Conclusions:
MAR is a potential new indicator for differential diagnosis of HCC and HBV, and also an independent risk factor for HCC. The biomarker's dual reflection of inflammatory and metabolic pathways offers unique diagnostic value, warranting prospective validation.
