A Systematic Review on Clinicopathological Evaluation of Neutrophil-Percentage-To-Albumin-Ratio (NPAR): An Emerging Biomarker for Hepato-Pathology and Hepato-Oncology
Background: The Neutrophil Percentage to Albumin Ratio (NPAR) proved to be an advanced combined pathological marker for assessing hepatopathology and hepatocellular carcinoma (HCC). The diagnostic value of NPAR remained unclear because research on its clinical applications and performance in contr...
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| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
ziauddin University
2025-04-01
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| Series: | Pakistan Journal of Medicine and Dentistry |
| Subjects: | |
| Online Access: | https://ojs.zu.edu.pk/pjmd/article/view/3501 |
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| Summary: | Background: The Neutrophil Percentage to Albumin Ratio (NPAR) proved to be an advanced combined pathological marker for assessing hepatopathology and hepatocellular carcinoma (HCC). The diagnostic value of NPAR remained unclear because research on its clinical applications and performance in contrast to typical biomarkers remains scarce. The goal of this evaluation was to methodically analyze and assess NPAR’s role as a biomarker in the examination of hepatopathology and hepatocellular carcinoma.
Methods: A systematic review in line with PRISMA guidelines used MEDLINE, Scopus, and Web of Science databases to access research articles published from January 2010 to January 2025. The research included original peer-reviewed studies and systematic reviews in the English language that examined the link between NPAR and liver diseases alongside HCC cases. Researchers excluded articles that were not peer-reviewed, along with abstracts and studies lacking complete or sufficient data etc. The researchers evaluated studies based on their research methods, NPAR threshold requirements, and diagnostic capabilities in actual clinical practice. Study bias risk was evaluated through analysis of the Evidence Project Risk of Bias Tool. The authors performed a qualitative data synthesis to provide a comparative understanding of NPAR’s therapeutic relevance.
Results: The initial search yielded 89 articles, which were screened based on inclusion criteria. After reviewing titles and abstracts, 30 articles met the inclusion criteria. Following full-text review, 12 studies were selected for final analysis. Participant samples ranged from 100 to 3000 individuals. Numerous studies in the review examined NPAR's performance as both a diagnostic and prognostic indicator. NPAR proved to be a superior marker to standard biomarkers ALT, AST, and bilirubin for chronic liver disease and HCC diagnosis in most published studies. Clinical implementation of NPAR showed effective results in high-risk patient screening, disease progression tracking, and survival outcome estimation. Research combined NPAR measurements with other biomarkers to demonstrate how it could work with multiple diagnostic markers.
Discussion: The Neutrophil Percentage to Albumin Ratio (NPAR) has proven itself as a vital biomarker for managing liver diseases and hepatocellular carcinoma. The medical field needed sustained, large-scale assessments to establish NPAR's worth as a diagnostic tool, prognostic indicator, and therapeutic target in hepatopathology and hepatocellular carcinoma.
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| ISSN: | 2313-7371 2308-2593 |