Research Article

Influence of Alanine Transaminase Levels on Alpha-Fetoprotein for Predicting Hepatocellular Carcinoma in Patients with Hepatitis B Infection

Table 4

Performance of AFP and the ratio for the diagnosis of HCC in patients with different ALT levels.

ParameterCutoffAUC (95% CI) value#SensitivitySpecificityLR+LR-

AFP (ng/mL)<0.001
 Total cohort7.80.725 (0.691-0.756)0.65 (0.58-0.71)0.72 (0.68-0.75)2.27 (2.0-2.5)0.49 (0.4-0.6)
 Cohort with ULN7.80.806 (0.771-0.837)0.63 (0.56-0.70)0.88 (0.84-0.91)5.07 (4.5-5.7)0.42 (0.3-0.6)
 Cohort with ULN88.30.611 (0.535-0.683)0.52 (0.33-0.71)0.76 (0.68-0.83)2.15 (1.5-3.1)0.64 (0.4-1.0)
(10-3)&0.68
 Total cohort18.00.769 (0.737-0.799)0.50 (0.44-0.57)0.91 (0.88-0.93)5.32 (4.7-6.1)0.55 (0.4-0.7)
 Cohort with ULN28.30.745 (0.707-0.780)0.46 (0.40-0.53)0.95 (0.93-0.97)9.92 (8.6-11.5)0.56 (0.3-0.9)
 Cohort with ULN5.60.769 (0.700-0.829)0.59 (0.39-0.77)0.86 (0.79-0.91)4.13 (3.0-5.6)0.48 (0.3-0.9)

AFP: alpha-fetoprotein; ALT: alanine aminotransferase; AST: aspartate aminotransferase; HCC: hepatocellular carcinoma; AUC: area under the receiver operating characteristic curve; CI: confidence interval; LR+: positive likelihood ratio; LR-: negative likelihood ratio; ULN: upper limit of normal. &For the convenience of representation, the value of was 1000 times the actual value. # value was calculated for comparison of AUCs in patients with ULN and those with ULN.