The Applicability of ADA, AFU, and LAC in the Early Diagnosis and Disease Risk Assessment of Hepatitis B-Associated Liver Cirrhosis and Hepatocellular Carcinoma

Wei Zhang; Zhong Chen; Chengjun Xue; Yao Zhang; Lipei Wu; Jichao Zhu; Shihai Xuan; Jiale Tian; Zhi Pang

doi:10.3389/fmed.2021.740029

The Applicability of ADA, AFU, and LAC in the Early Diagnosis and Disease Risk Assessment of Hepatitis B-Associated Liver Cirrhosis and Hepatocellular Carcinoma

Front Med (Lausanne). 2021 Sep 7:8:740029. doi: 10.3389/fmed.2021.740029. eCollection 2021.

Authors

Wei Zhang¹, Zhong Chen², Chengjun Xue³, Yao Zhang², Lipei Wu⁴, Jichao Zhu⁵, Shihai Xuan⁴, Jiale Tian⁶, Zhi Pang⁷

Affiliations

¹ Department of Laboratory Medicine, Jiaozuo Fifth People's Hospital, Jiaozuo, China.
² Department of Laboratory Medicine, Luoyang Hospital of Traditional Chinese Medicine, The Affiliated Hospital of Henan University of Chinese Medicine, Luoyang, China.
³ Department of Gastroenterology, Jianhu Hospital of Nantong University, Yancheng, China.
⁴ Department of Laboratory Medicine, Dongtai People's Hospital & Dongtai Hospital of Nantong University, Yancheng, China.
⁵ Department of Laboratory Medicine, Huzhou Central Hospital, Affiliated Central Hospital of Huzhou Normal University, Huzhou, China.
⁶ Department of Laboratory Medicine, Tongji Hospital, Tongji University School of Medcine, Shanghai, China.
⁷ Department of Gastroenterology, The North District of the Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou, China.

Abstract

Objective: This study aimed to evaluate the applicability of adenosine deaminase (ADA), α-l-fucosidase (AFU), lactic acid (LAC), and their combined detection in the early diagnosis of chronic hepatitis B (CHB), liver cirrhosis (LC), and hepatocellular carcinoma (HCC). Methods: A retrospective analysis of hepatitis B-positive liver disease patients admitted between 2015 and 2020 was conducted. The receiver operating characteristic (ROC) curve was used to determine the diagnostic value of each indicator in LC and HCC, and binary logistic regression analysis was performed to determine the factors and risks related to the occurrence of the two conditions. Results: The levels of ADA, AFU, and LAC were significantly increased in patients with CHB, LC, and HCC (p < 0.05). The ROC curve showed that the sensitivity and specificity of ADA, AFU, LAC, and their combined detection in the CHB and LC groups as well as in the LC and HCC groups reflected different degrees of clinical value. In the CHB and LC groups, the adjusted odds ratio (OR) values of ADA, AFU, and LAC among patients in the high-level group were 3.218, 1.859, and 11.474, respectively, when the median was considered the cutoff point. When quartiles were considered the cutoff point, the OR risk values of the adjusted levels of ADA, AFU, and LAC were higher than those of the lowest-level group (Q1) (p < 0.05). In the LC and HCC groups, the adjusted OR values of ADA, AFU, and LAC among patients in the high-level group were 0.967, 2.365, and 38.368, respectively. When quartiles were considered the cutoff point, the OR risk values of AFU and LAC levels were higher than those of the lowest-level group (Q1) (p < 0.05). Conclusion: ADA, AFU, and LAC demonstrated good value in the early diagnosis of LC and HCC. The combined detection of ADA+AFU+LAC is more effective than single detection for the early diagnosis of the two conditions. ADA, AFU, and LAC can serve as risk predictors of LC, while AFU and LAC can be considered early risk predictors of HCC.

Keywords: ADA; AFU; LAC; diagnostic value; hepatitis; hepatocellular carcinoma; liver cirrhosis; risk assessment.