Journal of Hepatocellular Carcinoma (Jan 2023)

Evaluation of Lactate Dehydrogenase and Alkaline Phosphatase as Predictive Biomarkers in the Prognosis of Hepatocellular Carcinoma and Development of a New Nomogram

  • Su K,
  • Huang W,
  • Li X,
  • Xu K,
  • Gu T,
  • Liu Y,
  • Song J,
  • Qian K,
  • Xu Y,
  • Zeng H,
  • Yang Y,
  • Guo L,
  • Han Y

Journal volume & issue
Vol. Volume 10
pp. 69 – 79

Abstract

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Ke Su,1,* Weihong Huang,2,* Xueting Li,3,* Ke Xu,4,* Tao Gu,1 Yanlin Liu,1 Juan Song,2 Keyi Qian,5 Yaoyang Xu,2 Hao Zeng,1 Yipei Yang,6 Lu Guo,7 Yunwei Han1 1Department of Oncology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People’s Republic of China; 2Clinical Medical College, Southwest Medical University, Luzhou, 646000, People’s Republic of China; 3Department of Oncology, 363 Hospital, Chengdu, 610041, People’s Republic of China; 4Department of Oncology, Chongqing General Hospital, Chongqing, 401147, People’s Republic of China; 5Department of Nursing, Sichuan University, Chengdu, 610065, People’s Republic of China; 6Department of Orthopedic Surgery, Shenzhen Hospital, Southern Medical University, Shenzhen, 518000, People’s Republic of China; 7Department of Ophthalmology, The Affiliated Hospital of Southwest Medical University, Luzhou, 646000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Yunwei Han; Lu Guo, The Affiliated Hospital of Southwest Medical University, 25 TAIPING Street, Luzhou City, Sichuan Province, People’s Republic of China, Tel +86-830-3165598 ; +86-830-3165613, Email [email protected]; [email protected]: Tumor proliferation is frequently accompanied by aberrant enzyme production. We aim to investigate the potential predictive value of both plasma alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) in patients with HCC and to develop a nomogram to assess the prognosis of HCC.Methods: The trial involved 2327 patients between May 2015 and March 2022. Within 7 days of enrollment, the levels of ALP and LDH were measured, and their association with survival was assessed. And we had developed and validated a new nomogram based on ALD and ALP.Results: Using X-tile software, the optimal cut-off values were determined to be ALP = 172 U/L and LDH = 241 U/L. The high ALP (≥ 172), LDH (≥ 241), and ALP/LDH (≥ 0.91) groups had lower median overall survival (mOS) than low ALP (< 172), LDH (< 241), and ALP/LDH (< 0.91) groups (all p < 0.001). In addition, elevated ALP and LDH levels are independent negative prognostic indicators. Moreover, we established that the area under the curve (AUC) values of the predicted 1-, 2-, and 3-year survival rates of receiver operating characteristic curve (ROC) based on the nomogram were 0.79, 0.77, and 0.74, respectively. In addition, the calibration curves and decision curve analyses (DCA) demonstrated that this model possessed strong predictive capability.Conclusion: ALP, LDH and ALP/LDH can be employed as biomarkers for predicting the prognosis of HCC. Furthermore, the nomograph based on ALH and ALP demonstrates good HCC prediction performance. For HCC patients with high ALH or ALP or ALP/LDH, close surveillance program and adjuvant therapy should be considered.Keywords: lactate dehydrogenase, alkaline phosphatase, hepatocellular carcinoma, overall survival, nomogram

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