Table 2.

Prognostic significance of serum ALB/ALP ratio in HCC patients.

Biomarkers	Patients	Prognostic Significance	Year	References
Pre-treatment ALB/ALP ratio a	217 patients with HCC treated with curative surgical resection (as training cohort); 256 patients with HCC treated with curative surgical resection; and 425 patients with HCC treated with transarterial therapy, systemic chemotherapy, or supportive care (as 2 validation cohorts).	Low ALB/ALP ratio predicted worse OS and DFS (<0.23 vs. ≥0.23).	2015	Chan et al. [33]
	221 HBV-infected patients with HCC treated with curative surgical resection.	Low ALB/ALP ratio predicted worse OS and RFS (≤0.40 vs. >0.40).	2020	Li et al. [34]
	267 patients with combined HCC and cholangiocarcinoma treated with curative surgical resection (187 as training cohort and 80 as validation cohort).	Low ALB/ALP ratio predicted worse OS (≤0.43 vs. >0.43).	2020	Zhang et al. [35]
	210 patients with HCC treated with liver transplantation.	Low ALB/ALP ratio predicted worse OS (≤0.38 vs. >0.38).	2020	Li et al. [36]
	445 patients with HCC treated with RFA (297 as training cohort and 148 as validation cohort).	Low ALB/ALP ratio predicted worse OS and RFS (≤0.40 vs. >0.40).	2021	Zhang et al. [37]
	372 patients with HCC treated with TACE (as training cohort); 82 patients with HCC treated with TACE; and 202 patients with HCC treated with supportive care (as 2 validation cohorts).	Low ALB/ALP ratio predicted worse OS (≤0.439 vs. >0.439).	2018	Chen et al. [38]
	237 patients with advanced HCC treated without any standard anti-cancer therapies.	Low ALB/ALP ratio predicted worse OS (≤0.38 vs. >0.38).	2018	Cai et al. [39]

^a ALB/ALP ratio was calculated by dividing serum ALB level (g/L) by serum ALP level (IU/L). Abbreviations: ALB—albumin; ALP—alkaline phosphatase; HCC—hepatocellular carcinoma; OS—overall survival; DFS—disease-free survival; TACE—transarterial chemoembolization; HBV—hepatitis B virus; RFS—recurrence-free survival; RFA—radiofrequency ablation; vs.—versus.