摘要
目的旨在探讨新型炎症复合指标对术前鉴别肝内胆管癌(ICC)及肝细胞癌(HCC)的临床价值。方法收集2016年1月至2022年5月于右江民族医学院附属医院消化内科及肿瘤科就诊的243例原发性肝癌患者,根据病理结果将研究对象分为ICC组(121例)和HCC组(122例)。对两组患者的一般资料及实验室指标进行统计学分析。结果①经非参数检验ICC组患者外周血白细胞、中性粒细胞、血小板、C反应蛋白、天门冬氨酸氨基转移酶、碱性磷酸酶、中性粒细胞/淋巴细胞比值(NLR)、C反应蛋白/白蛋白比值(CAR)、碱性磷酸酶/淋巴细胞比值(ALR)、血小板/淋巴细胞比值(PLR)水平高于HCC组(P<0.05),淋巴细胞、单核细胞、白蛋白水平低于HCC组(P<0.05)。②白细胞、中性粒细胞、淋巴细胞、单核细胞、C反应蛋白、血小板、天门冬氨酸氨基转移酶、碱性磷酸酶、NLR、CAR、ALR、PLR在两组鉴别诊断中的受试者工作特征曲线下面积(AUC)均有统计学意义(P<0.05),其中以PLR的AUC最高,为0.802,在最佳界值下,灵敏度为0.777,特异度为0.746。结论新型炎症复合指标NLR、CAR、ALR、PLR在肝癌患者的术前鉴别诊断中均具有一定的辅助价值,临床上可酌情考虑采用复合指标提高鉴别诊断效率。
Objective To investigate the clinical value of novel composite markers of inflammation in differential diagnosis of intrahepatic cholangiocarcinoma(ICC)and hepatocellular carcinoma(HCC)before surgery.Methods This study collected a total of 243 patients with primary liver cancer who were treated in the Department of Gastroenterology and Oncology,Youjiang Medical University for Nationalities from January 2016 to May 2022.The study subjects were divided into ICC group(121 patients)and HCC group(122 patients)according to their pathological results.The general information and laboratory indicators of the two groups were statistically analyzed.Results①The non-parametric test showed that the patients in the ICC group had higher levels of white blood cells,neutrophils,platelets,C-reactive proteins,aspartate aminotransferase,alkaline phosphatase,neutrophil to lymphocyte ratio(NLR),C-reactive protein to albumin ratio(CAR),alkaline phosphatase to lymphocyte ratio(ALR)and platelet to lymphocyte ratio(PLR)than the HCC group(P<0.05),but had lower levels of lymphocytes,monocytes and albumin levels than the HCC group(P<0.05).②The differential diagnosis of these two groups had significant difference in AUCs[the area under the receiver operating characteristic curve(ROC)]of white blood cells,neutrophils,lymphocytes,monocytes,C-reactive proteins,platelets,aspartate aminotransferase,alkaline phosphatase,NLR,CAR,ALR,and PLR(P<0.05).Thereinto,the AUC of PLR was the highest(0.802).Under the optimal threshold,its sensitivity was 0.777 and specificity 0.746.Conclusion The novel composite markers NLR,CAR,ALR and PLR for inflammation have certain auxiliary value for the differential diagnosis of HCC before surgery.Composite indicators can be considered to improve the efficiency of differential diagnosis in clinical practice.
作者
张寒
韦华
Zhang Han;Wei Hua(Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China;The Affiliated Hospital of Youjiang Medical University for Nationalities,Baise 533000,Guangxi,China)
出处
《右江民族医学院学报》
2022年第6期856-860,共5页
Journal of Youjiang Medical University for Nationalities
基金
广西自然科学基金项目(2021GXNSFAA325002)。
关键词
胆管上皮癌
癌
肝细胞
新型炎症指标
chalangiocarcinoma
carcinoma,hepatocyte
novel inflammatory markers
