Prognostic value of aspartate aminotransferase to platelet ratio index as a noninvasive biomarker in patients with hepatocellular carcinoma: a meta-analysis

Background: The aspartate aminotransferase-to-platelet ratio index (APRI) has been correlated with clinical outcome in patients with hepatocellular carcinoma (HCC), but controversial results were obtained with previous studies. This study was aimed to evaluate the prognostic value of the APRI in patients with HCC. Materials and methods: A literature survey was conducted by searching PubMed, Web of Science, Cochrane library, Embase, Wanfang, and National Knowledge Infrastructure for publications released prior to March 1, 2018. Pooled hazard ratios (HRs) with 95% CIs were calculated to assess the association between the APRI and HCC prognosis using Stata SE 12.0 software. Results: Analysis was performed on a total of 15 articles that included 5,051 patients. The pooled results showed that APRI was significantly associated with overall survival for patients with HCC (HR = 1.62, 95% CI: 1.23-2.01). Furthermore, HCC patients with higher APRI were at significantly greater risk of short recurrence-free survival (HR = 1.83, 95% CI: 1.48-2.18) and poor disease-free survival (HR = 1.46, 95% CI: 1.26-1.66). Conclusions: APRI could serve as a promising and noninvasive marker for predicting HCC prognosis.