Table 3. Subgroup analysis of the eligible studies on high pre-treatment serum AFP-L3% associated with OS/DFS in HCC.
Analysis | No. ofstudies | Pooled hazardratio (95% CI) | I 2 statistic(%) | x 2 p-value forheterogeneity | x 2 p-value forsubgroup differences | Analytical model |
OS | ||||||
Therapeutic method | ||||||
Surgical resection7,8,20,21 | 4 | 1.54 (1.21–1.96) | 35 | 0.20 | REM | |
RFA19,21,23 | 3 | 1.50 (1.24–1.81) | 0 | 0.78 | REM | |
Multiple treatment9,17,25,26 | 4 | 1.97 (1.51–2.58) | 0 | 0.68 | 0.24 | REM |
Viral infection | ||||||
HCV infection ≥50%8,9,17,19–23,25,26 | 11 | 1.57 (1.38–1.79) | 7 | 0.38 | REM | |
HBV infection ≥50%6,7 | 2 | 2.28 (1.32–3.95) | 29 | 0.24 | 0.20 | REM |
AFP-L3 detection method | ||||||
Highly sensitive19,20 | 2 | 1.55 (1.16–2.08) | 0 | 0.54 | REM | |
Conventional6–9,21,22,25 | 8 | 1.80 (1.44–2.25) | 41 | 0.11 | 0.43 | REM |
AFP concentration | ||||||
Low9,19 | 2 | 1.96 (1.24–3.10) | 0 | 0.69 | REM | |
High6–8,17,20–23,25,26 | 11 | 1.65 (1.42–1.91) | 27 | 0.19 | 0.47 | REM |
Study design | ||||||
Prospective design9,21,23 | 3 | 1.42 (1.22–1.66) | 0 | 0.55 | REM | |
Retrospective design8,17, 25 | 3 | 2.27 (1.57–3.28) | 0 | 0.68 | 0.02 | REM |
DFS | ||||||
Therapeutic method | ||||||
Surgical resection7,8,20 | 3 | 2.02 (1.37–2.99) | 30 | 0.24 | REM | |
RFA19,24 | 2 | 1.73 (1.10–2.71) | 10 | 0.29 | REM | |
Multiple treatment10,18 | 2 | 1.72 (1.27–2.32) | 0 | 0.49 | 0.79 | REM |
Viral infection | ||||||
HBV infection ≥50%7 | 1 | 2.44 (1.43–4.13) | Not applicable | Not applicable | REM | |
HCV infection ≥50%8,10,18–20,24 | 6 | 1.72 (1.40–2.10) | 0 | 0.64 | 0.23 | REM |
AFP-L3 detection method | ||||||
Highly sensitive18–20 | 3 | 1.63 (1.32–2.03) | 0 | 0.75 | REM | |
Conventional7,8,10 | 3 | 2.44 (1.66–3.59) | 0 | 0.79 | 0.08 | REM |
AFP concentration | ||||||
Low19 | 1 | 2.53 (1.09–5.89) | Not applicable | Not applicable | REM | |
High7,8,10,18,20,24 | 6 | 1.76 (1.45–2.14) | 0 | 0.53 | 0.41 | REM |
Study design | ||||||
Retrospective design8,18, 24 | 3 | 1.67 (1.28–2.17) | 0 | 0.39 | REM |
CI, confidence interval; REM, random-effect model; DFS, disease-free survival; OS, overall survival; RFA, radiofrequency ablation; AFP, α-fetoprotein; AFP-L3, lens culinaris agglutinin-reactive fraction of α-fetoprotein; HBV, hepatitis B virus; HCV, hepatitis C virus.