Table 4.

Diagnostic performances of combinations of four serum biomarkers for differentiating HCC from liver disease using AFP = 20 ng/mL as cutoff value

Markers	AUC	Sensitivity (Sn)	Specificity (Sp)	Sn + Sp	PPV	NPV
AFP + NLR	0.762 (0.724–0.795)	0.772 (0.727–0.812)	0.739 (0.669–0.798)	1.511	0.861 (0.820–0.894)	0.608 (0.541–0.671)
AFP + ALT	0.697 (0.657–0.734)	0.694 (0.654–0.731)	0.807 (0.742–0.858)	1.501	0.874 (0.829–0.909)	0.516 (0.4458–0.575)
AFP + AST	0.749 (0.711–0.783)	0.889 (0.853–0.917)	0.470 (0.394–0.540)	1.359	0.777 (0.735–0.813)	0.667 (0.579–0.744)
ALT+AST	0.694 (0.654–0.731)	0.802 (0.759–0.840)	0.470 (0.394–0.540)	1.272	0.759 (0.714–0.799)	0.529 (0.451–0.606)
NLR + ALT	0.653 (0.612–0.692)	0.596 (0.545–0.645)	0.773 (0.705–0.828)	1.369	0.846 (0.797–0.885)	0.477 (0.420–0.535)
NLR + AST	0.736 (0.697–0.771)	0.892 (0.856–0.919)	0.409 (0.339–0.483)	1.301	0.760 (0.717–0.798)	0.643 (0.551–0.726)
AFP + AST + ALT	0.749 (0.711–0.783)	0.889 (0.853–0.917)	0.470 (0.394–0.540)	1.359	0.777 (0.735–0.813)	0.667 (0.579–0.744)
NLR + AST + ALT	0.736 (0.697–0.771)	0.892 (0.856–0.919)	0.409 (0.339–0.483)	1.301	0.760 (0.717–0.798)	0.643 (0.551–0.726)
AFP + NLR + ALT	0.765 (0.728–0.799)	0.799 (0.759–0.835)	0.699 (0.627–0.762)	1.498	0.847 (0.806–0.881)	0.621 (0.552–0.686)
AFP + NLR + AST	0.762 (0.724–0.795)	0.930 (0.899–0.952)	0.409 (0.339–0.484)	1.339	0.767 (0.73–0.804)	0.736 (0.640–0.812)
AFP + AST + ALT+NLR	0.762 (0.724–0.795)	0.930 (0.8998–0.952	0.409 (0.339–0.484)	1.339	0.767 (0.73–0.804)	0.736 (0.640–0.812)

HCC, hepatocellular carcinoma; ALT, alanine aminotransferase; AST, aspartate aminotransferase; AFP, alpha-fetoprotein; NLR, neutrophil-granulocyte ratio; AUC, area under the receiver operating characteristic curve