Abstract: Objective To evaluate the value of fibrinogen/prealbumin ratio (FPR) and γ-glutamyl transpeptidase/platelet ratio (GPR) in alpha-fetoprotein-negative hepatocellular carcinoma (AFP-N HCC). Methods From March 2018 to March 2020, there were 80 AFP-N HCC patients (58 males and 22 females) with an average age of (50.2 ± 9.8) years, and 100 patients undergoing physical examination (60 males and 40 females) with an average age of (49.8 ± 6.2) years enrolled in the study. The independent predictive factors of AFP-N HCC were analyzed by Logistic regression. Cut-off points for diagnosing AFP-N HCC were determined by receiver operating characteristic (ROC) curve, and the diagnostic efficiency was calculated. Results There were significant differences in platelet, hemoglobin, fibrinogen, phosphatidic acid, alanine transaminase (ALT), aspartate transaminase, total bilirubin, gamma-glutamyl transpeptidase, FPR and GPR between AFP-N HCC group and healthy group (P<0.05). Logistic regression analysis showed that ALT, FPR and GPR were independent factors for AFP-N HCC (P<0.05). The cut-off value of FPR for diagnosing AFP-N HCC was 11.60, with area under the curve (AUC) [95% confidence interval (CI)] of 0.94 (0.90-0.96), sensitivity of 86.5%, and specificity of 88.4%. The cut-off value of GPR for diagnosing AFP-N HCC was 0.21, with AUC (95% CI) of 0.89 (0.85-0.92), sensitivity of 68.4% and specificity of 94.8%. Combining FPR and GPR, the AUC (95% CI), sensitivity and specificity were 0.97 (0.95-0.99), 91.0% and 96.2%, respectively. Conclusion FPR and GPR can be used for the diagnosis of AFP-N HCC. The combination of FPR and GPR has better diagnostic value.

Key words: Alpha-fetoprotein-negative hepatocellular carcinoma, Ratio of fibrinogen to prealbumin, Ratio of gamma-glutamyl transpeptidase to platelet