Purpose: This study aimed to analyze the result of hepatocellular carcinoma (HCC) diagnosis using α-L-fucosidase (AFU) and determine the optimal scale for the threshold. Methods: A comprehensive literature search of PubMed, EMbase, Medline, Cochrane Library, and Google Scholar was conducted. Information regarding the threshold, sensitivity, and specificity of AFU for diagnosing HCC was extracted. Corresponding Youden’s indices were derived, and ROC values were calculated using the meta-analyses method. Results: Sixteen studies were included in this study. When the threshold was <10 µmol/L/min or 10-20 umol/L/min, the average values of Youden’s index were 0.54, and when the threshold was 30-40 and >40, the average values of Youden’s index were 0.45 and 0.31, respectively. However, when the threshold was 20-30, the average value of Youden’s index one was 0.62, the highest. When the threshold was 20-30, the DOR average value was also the highest. Conclusion: The optimal threshold was 20-30 umol/L/min in the serum AFU test for HCC diagnosis. DOR can be used as an auxiliary index with the AFU-based HCC diagnosis.
