Dual-parameter liquid biopsy using plasma miR-21-5p and T cell LAIR-1 mean fluorescence intensity for hepatocellular carcinoma diagnosis in a high-risk Egyptian cohort

Table 11 Synthesis of biomarker performance and clinical relevance for hepatocellular carcinoma diagnosis

Biomarker	Diagnostic performance (AUC)	Key strength	Role in multivariable model	Correlation with disease severity
hsa-miR-21-5p	0.990 (exceptional)	Very high sensitivity (98.6%) and specificity (96.7%)	Not an independent predictor (P = 0.899)	Strong correlation with AFP (ρ = 0.812); associated with metastasis
hsa-miR-155-5p	0.874 (good)	Good specificity (93.3%)	Not an independent predictor (P = 0.789)	Not assessed in this context
LAIR-1+ T cell %	0.833 (good)	Perfect specificity (100%) as a rule-in test	Not tested in the primary model	Strong correlation with LAIR-1 MFI (ρ = 0.714)
LAIR-1 MFI	0.997 (exceptional)	Perfect sensitivity (100%) and high specificity (98.3%)	Sole independent predictor (OR = 1.48, P = 0.028)	Associated with vascular invasion and metastasis
Combined model	0.998 (near-perfect)	Superior net benefit for clinical decision-making	N/A	N/A

Diagnostic performance for discriminating hepatocellular carcinoma from liver cirrhosis. The combined model included hsa-miR-21-5p, hsa-miR-155-5p, leukocyte-associated immunoglobulin-like receptor-1, mean fluorescence intensity, and alpha-fetoprotein. AUC: Area under the curve; LAIR-1: Leukocyte-associated immunoglobulin-like receptor-1; MFI: Mean fluorescence intensity; AFP: α-fetoprotein; N/A: Not applicable; OR: Odds ratio.