Table 2.
The diagnostic efficacy of preoperative FPR, AFR, CEA, CA19-9, and FPR combined with CEA and CA19-9 in patients with colorectal non-neoplastic polyps, adenomas, and early-stage colorectal cancer in discovery and validation cohorts and overall population
| Comparison | Biomarkers | Cut-off value |
AUC | Sensitivity (%) |
Specificity (%) |
PPV (%) |
NPV (%) |
Youden’s index |
|
|---|---|---|---|---|---|---|---|---|---|
| Discovery cohort | Non-neoplastic polyps vs. adnomas | FPR | 6.17 | 0.576 | 91.10 | 14.20 | 78.70 | 31.40 | 0.053 |
| AFR | 22.69 | 0.549 | 12.90 | 87.10 | 77.78 | 77.65 | 0.027 | ||
| CEA | 1.245 | 0.507 | 57.80 | 48.10 | 23.59 | 80.48 | 0.059 | ||
| CA19-9 | 8.165 | 0.528 | 70.40 | 38.80 | 80.60 | 26.63 | 0.095 | ||
| Adnomas vs. early-stage CRC | FPR | 11.73 | 0.818 | 70.60 | 79.70 | 80.37 | 69.67 | 0.503 | |
| AFR | 14.90 | 0.767 | 76.10 | 66.90 | 66.11 | 76.74 | 0.430 | ||
| CEA | 1.895 | 0.711 | 63.80 | 68.30 | 70.38 | 61.58 | 0.321 | ||
| CA19-9 | 16.895 | 0.577 | 41.60 | 73.30 | 64.67 | 51.60 | 0.149 | ||
| CEA+FPR | 0.63 | 0.858 | 67.10 | 90.90 | 89.70 | 70.11 | 0.580 | ||
| CEA+CA19-9+FPR | 0.62 | 0.858 | 67.10 | 90.70 | 89.46 | 70.06 | 0.578 | ||
| Colorectal benign polyps vs. early-stage CRC | FPR | 12.47 | 0.792 | 65.10 | 81.30 | 72.25 | 71.62 | 0.464 | |
| AFR | 14.90 | 0.754 | 75.50 | 33.10 | 54.98 | 55.44 | 0.424 | ||
| CEA | 1.875 | 0.711 | 63.80 | 69.40 | 65.83 | 67.51 | 0.332 | ||
| CA19-9 | 16.86 | 0.582 | 41.80 | 73.60 | 59.88 | 57.86 | 0.154 | ||
| CEA+FPR | 0.50 | 0.835 | 68.30 | 83.40 | 79.11 | 74.04 | 0.525 | ||
| CEA+CA19-9+FPR | 0.50 | 0.835 | 68.60 | 83.90 | 79.72 | 74.30 | 0.525 | ||
|
Validation cohort |
Colorectal benign polyps vs. early-stage CRC | FPR | 12.47 | 0.759 | 72.30 | 68.20 | 69.52 | 79.98 | 0.405 |
| AFR | 14.90 | 0.703 | 70.60 | 65.30 | 67.14 | 68.95 | 0.359 | ||
| CEA | 1.875 | 0.702 | 58.90 | 68.20 | 65.03 | 62.27 | 0.271 | ||
| CA19-9 | 16.86 | 0.579 | 43.60 | 73.10 | 61.97 | 56.32 | 0.167 | ||
| CEA+FPR | 0.50 | 0.823 | 61.90 | 83.60 | 79.11 | 68.57 | 0.455 | ||
| CEA+CA19-9+FPR | 0.50 | 0.823 | 61.90 | 83.60 | 79.11 | 68.57 | 0.455 | ||
|
Overall population |
Colorectal benign polyps vs. early-stage CRC | FPR | 12.47 | 0.780 | 67.20 | 77.80 | 69.08 | 76.27 | 0.450 |
| AFR | 14.90 | 0.742 | 74.00 | 66.40 | 60.97 | 75.70 | 0.404 | ||
| CEA | 1.875 | 0.709 | 62.40 | 68.40 | 59.29 | 71.12 | 0.308 | ||
| CA19-9 | 16.86 | 0.580 | 42.20 | 73.50 | 29.75 | 38.33 | 0.157 | ||
| CEA+FPR | 0.50 | 0.829 | 63.20 | 86.00 | 76.96 | 76.81 | 0.492 | ||
| CEA+CA19-9+FPR | 0.50 | 0.828 | 64.00 | 85.70 | 76.05 | 76.38 | 0.497 | ||
FPR = Fib/pAlb × 1000; AFR = Alb/Fib
CRC colorectal cancer; benign colorectal polyps include colorectal non-neoplastic and adenomatous polyps; Fib Fibrinogen; Alb albumin; pAlb pre-albumin; PPV positive predictive value; NPV negative predictive value; AUC area under curve