摘要
目的探究全身免疫炎症指标,包括全身免疫炎症指数(systemic immune-inflammation index,SII)、中性粒细胞-淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板-淋巴细胞比值(platelet to lymphocyte ratio,PLR)及单核细胞-淋巴细胞比值(monocyte-lymphocyte ratio,MLR)对原发性胆汁性胆管炎(primary biliary cholangitis,PBC)患者肝癌发生的预测价值。方法回顾性分析了从2010年至2021年北京佑安医院835例来院诊疗的PBC患者,并且收集了他们初次来我院被诊断为PBC时的人口统计学相关信息和实验室检查结果。首先,比较了最终发生肝癌组和未发生肝癌组间基线水平的血常规、肝生化及免疫相关抗体指标的差异性,随后利用Cox回归模型筛选出了PBC相关肝癌的危险因素,最后根据ROC曲线下面积(AUC)比较不同指标对PBC相关肝癌发生的预测价值。结果年龄、存在肝硬化是PBC相关肝癌的危险因素。此外,对于预测肝癌发生的全身免疫炎症指标,我们的结果表明MLR较其他指标可以更好地预测PBC患者肝癌的发生。结论在PBC患者中,将MLR添加到目前的计算指标中,用于PBC发生肝癌的高危患者的早期预警,增加该部分患者的常规检测频率,可能有助于及时监测到患者的肝癌发生,以提供早期且更合适的治疗选择。
Objective To explore the predictive value of systemic immune-inflammatory indicators,including systemic immune-inflammation index(SII),neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and monocyte to lymphocyte ratio(MLR),for the occurrence of hepatocellular carcinoma(HCC)in patients with primary biliary cholangitis(PBC).Methods A retrospective analysis was conducted on 835 PBC patients admitted to Beijing You’an Hospital from 2010 to 2021.Demographic information and laboratory test results were collected at the time of initial diagnosis of PBC.With this dataset,firstly,the differences in baseline levels of routine blood tests,liver biochemistry,and immunological antibodies between the group eventually developing HCC and the group not developing HCC were compared.Secondly,Cox regression model was utilized to identify risk factors for PBC-associated HCC.And finally,the predictive value of different indicators for the occurrence of PBC-associated HCC was compared based on the area under the receiver operating characteristic curve.Results Age and cirrhosis were risk factors for PBC-related HCC.In addition,regarding the predictive systemic immune-inflammatory indicators for HCC,our results indicated that MLR was able to better predict the occurrence of HCC in PBC patients than other indicators.Conclusion For PBC patients,adding MLR to the current calculation indicators for the early warning of HCC in high-risk patients with PBC,also increasing the frequency of routine testing for this subset of patients,could improve the timely detection the occurrence of HCC,which provides more appropriate treatment options.
作者
孙丽娜
王琪
刘新
时翰
徐斌
刘燕敏
张小丹
赵娟
杨雪
黄春洋
金荣华
SUN Lina;WANG Qi;LIU Xin;SHI Han;XU Bin;LIU Yanmin;ZHANG Xiaodan;ZHAO Juan;YANG Xue;HUANG Chunyang;JIN Ronghua(Beijing Institute of Hepatology,Beijing You’an Hospital,Capital Medical University,Beijing 100069,China;Beijing Key Laboratory of Emerging Infectious Diseases,Institute of Infectious Diseases,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China;Clinical Laboratory Center,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China;Second Department of Liver Disease,Beijing 100069)
出处
《标记免疫分析与临床》
CAS
2024年第6期986-991,共6页
Labeled Immunoassays and Clinical Medicine
基金
中国肝炎防治基金会王宝恩肝纤维化研究基金(编号:WBE2022018)
北京市医管局培育项目(编号:PX2019062)
首都医科大学附属北京佑安医院中青年人才孵育项目(编号:BJYAYY-YN-2022-09,BJYAYY-YN2023-14)。
关键词
原发性胆汁性胆管炎
肝癌
临床指标
预测
Primary biliary cholangitis
Hepatocellular carcinoma
Clinical indicators
Prediction
