The Relationship and Prognostic Significance of INR/Albumin Ratio with Radiological Data and AFP in Patients with Hepatocellular Carcinoma

INTRODUCTION: This study aimed to evaluate the relationship between the international normalized ratio-to-albumin ratio (IAR) and alpha-fetoprotein (AFP) levels, radiological findings, and prognosis in patients with hepatocellular carcinoma (HCC).
METHODS: A retrospective analysis was conducted on 115 HCC patients admitted between 2010 and 2023. IAR was calculated as INR divided by albumin. Patients were categorized into high (≥0.288) and low (<0.288) IAR groups. Radiological findings, AFP levels, Child-Pugh (CP) classification, model for end-stage liver disease score, tumor characteristics, and survival were compared between groups. The optimal IAR cutoff for predicting mortality was determined using receiver operating characteristic curve analysis.
RESULTS: A statistically significant positive correlation was observed between IAR and MELD score (p<0.001) and AFP levels (p=0.021). The optimal IAR cutoff was 0.267, with 80.2% sensitivity and 52.9% specificity. Patients with higher IAR had higher MELD scores, more tumors, worse CP classification, and higher mortality (p<0.05 for all).
DISCUSSION AND CONCLUSION: IAR is significantly associated with disease severity, tumor burden, and prognosis in HCC patients. It may serve as a simple, inexpensive, and non-invasive biomarker to guide early diagnosis, monitoring, and prognostic assessment in clinical practice.

Keywords: Albumin, hepatocellular carcinoma, international normalized ratio.