Retrospective Study
Copyright ©The Author(s) 2025. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Feb 27, 2025; 17(2): 99531
Published online Feb 27, 2025. doi: 10.4240/wjgs.v17.i2.99531
Prognostic value of combined detection of alpha-fetoprotein, plasma prothrombin activity, and serum prealbumin in acute-on-chronic liver failure
Rui-Xian Duan, Ling Liu, Yan Wang, Wen-Ming Wu
Rui-Xian Duan, Yan Wang, Department of Infectious Diseases, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Third Hospital of Shanxi Medical University, Tongji Shanxi Hospital, Taiyuan 030032, Shanxi Province, China
Ling Liu, Department of Pulmonary Diseases, Shanxi Provincial Integrated TCM and WM Hospital, Taiyuan 030013, Shanxi Province, China
Wen-Ming Wu, Clinical Laboratory, Shanxi Provincial People’s Hospital, Taiyuan 030023, Shanxi Province, China
Author contributions: Duan RX performed the study, designed the research and wrote the manuscript; Duan RX, Liu L, Wang Y, and Wu WM analyzed the data; and all authors have read and approve the final manuscript.
Institutional review board statement: This study was approved by the Ethic Committee of Shanxi Bethune Hospital.
Informed consent statement: The requirement for written informed consent was waived due to retrospective design of the study.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Data sharing statement: Dataset available from the corresponding author at wu.wenming1007@163.com.
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Wen-Ming Wu, Associate Chief Physician, Clinical Laboratory, Shanxi Provincial People’s Hospital, No. 359 Heping North Road, Jiancaoping District, Taiyuan 030023, Shanxi Province, China. wu.wenming1007@163.com
Received: October 11, 2024
Revised: November 11, 2024
Accepted: December 19, 2024
Published online: February 27, 2025
Processing time: 103 Days and 0.9 Hours
Abstract
BACKGROUND

Acute-on-chronic liver failure (ACLF) is a liver disease based on chronic liver disease, which is significantly influenced by clinical treatment regimen and disease status, and despite the existence of multiple prognostic assessment indicators for ACLF, the overall sensitivity and accuracy are relatively low.

AIM

To investigate the prognostic value of the combined detection of alpha-fetoprotein (AFP), plasma prothrombin activity (PTA), and serum prealbumin (PA) in ACLF.

METHODS

This retrospective study included 87 patients with ACLF admitted from February 2021 to February 2023 and categorized them into the survival (n = 47) and death (n = 40) groups according to their clinical outcomes 3 months posttreatment. All the participants underwent AFP, PTA, and PA level measurements upon admission. Baseline data, as well as AFP, PTA, and PA levels, were comparatively analyzed. Pearson correlation coefficients were utilized to analyze the correlations of AFP, PTA, and PA with different survival outcomes in patients with ACLF. Receiver operating characteristic (ROC) curves and areas under the curves were used to evaluate the predictive value of AFP, PTA, and PA for ACLF prognosis.

RESULTS

AFP, PTA, and PA levels were markedly decreased in the death group than in the survival group (P < 0.05). Pearson analysis indicated a positive association of the AFP, PTA, and PA levels with the survival of patients with ACLF (P < 0.05). ROC curve analysis determined the sensitivity and specificity of the combined diagnosis at 91.24% and 100.00%, respectively, both of which were notably increased compared to the single-index diagnosis. The ROC of their combined diagnosis was 0.989, significantly surpassing 0.907, 0.849, and 0.853 of AFP, PTA, and PA, respectively. No statistically significant variance was determined in the sensitivity and specificity of the combined diagnosis vs the single detection (P > 0.05).

CONCLUSION

The combined detection of AFP, PTA, and PA levels demonstrates favorable diagnostic value for the short-term prognosis of patients with ACLF, featuring high sensitivity and specificity.

Keywords: Alpha-fetoprotein; Prothrombin activity; Prealbumin; Acute-on-chronic liver failure; Prognostic value

Core Tip: Acute-on-chronic liver failure (ACLF) is a type of chronic hepatopathy-based liver disease featuring severe acute liver function. They are significantly influenced by clinical treatment regimens and disease conditions, with relatively low overall sensitivity and accuracy, despite the presence of multiple prognostic assessment indicators for ACLF. This study aims to investigate the prognostic value of the combined detection of alpha-fetoprotein, plasma prothrombin activity, and serum prealbumin in ACLF.