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张浩东, 魏丰贤, 张春芳, 徐小东. 血小板及其参数联合肿瘤标志物术前鉴别肝细胞癌及肝内胆管癌的临床价值[J]. 肿瘤防治研究, 2022, 49(3): 213-218. DOI: 10.3971/j.issn.1000-8578.2022.21.0898
引用本文: 张浩东, 魏丰贤, 张春芳, 徐小东. 血小板及其参数联合肿瘤标志物术前鉴别肝细胞癌及肝内胆管癌的临床价值[J]. 肿瘤防治研究, 2022, 49(3): 213-218. DOI: 10.3971/j.issn.1000-8578.2022.21.0898
ZHANG Haodong, WEI Fengxian, ZHANG Chunfang, XU Xiaodong. Clinical Value of Platelet and Its Parameters Combined with Tumor Markers in Preoperative Differentiation of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma[J]. Cancer Research on Prevention and Treatment, 2022, 49(3): 213-218. DOI: 10.3971/j.issn.1000-8578.2022.21.0898
Citation: ZHANG Haodong, WEI Fengxian, ZHANG Chunfang, XU Xiaodong. Clinical Value of Platelet and Its Parameters Combined with Tumor Markers in Preoperative Differentiation of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma[J]. Cancer Research on Prevention and Treatment, 2022, 49(3): 213-218. DOI: 10.3971/j.issn.1000-8578.2022.21.0898

血小板及其参数联合肿瘤标志物术前鉴别肝细胞癌及肝内胆管癌的临床价值

Clinical Value of Platelet and Its Parameters Combined with Tumor Markers in Preoperative Differentiation of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma

  • 摘要:
    目的 探讨血小板(PLT)及其参数和甲胎蛋白(AFP)、糖类抗原199(CA199)、糖类抗原125(CA125)及癌胚抗原(CEA)在术前肝细胞癌(HCC)及肝内胆管癌(ICC)鉴别诊断中的价值。
    方法 回顾性分析兰州大学第二医院行手术治疗的肝癌患者274例,据术后病理将其分为HCC组229例和ICC组45例。比较两组PLT及其参数和肿瘤标志物水平的差异;受试者工作特征(ROC)曲线评价有显著差异的指标进行单独和联合时对HCC和ICC的鉴别诊断效能,并将最佳方案应用于术前明确诊断和非明确诊断患者中进行验证。
    结果 与HCC组相比,ICC组的PLT、血小板压积(PCT)、CA199和CA125水平较高(P < 0.05),AFP水平较低(P < 0.05),其余指标差异无统计学意义(P > 0.05)。ROC曲线诊断分析结果显示:单独检测时,AFP对HCC诊断的曲线下面积(AUC)最大,为0.827。肿瘤标志物的联合方案均较单独方案的AUC大,其中以PCT+AFP+CA199+CA125联合方案鉴别诊断效能最佳,AUC为0.891。对最佳联合方案验证表明,其在术前明确诊断组的AUC为0.924,在非明确诊断组的AUC为0.854。
    结论 联合PLT、PCT可以增加现有肿瘤标志物单独对术前HCC和ICC的鉴别诊断效能。术前行PCT+AFP+CA199+CA125联合方案有助于进一步明确诊断和规划手术方案。

     

    Abstract:
    Objective To evaluate the value of PLT and its parameters combined with AFP, CA199, CA125 and CEA on the preoperative differential diagnosis of hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC).
    Methods We analyzed retrospectively 274 patients with liver cancer who underwent surgery in the Second Hospital of Lanzhou University. They were divided into 229 cases in HCC group and 45 cases in ICC group according to postoperative pathological results. The differences of PLT, its parameters and tumor markers between the two groups were compared. ROC curve was used to evaluate the differential diagnosis effect on HCC and ICC by significantly different indicators in single and combined forms. The best scheme was verified in the patients with determined and undetermined preoperative diagnosis.
    Results Compared with HCC group, the levels of PLT, PCT, CA199 and CA125 in ICC group were higher (P < 0.05) and the level of AFP was lower (P < 0.05). The diagnostic analysis results of ROC curve showed that in single test, the AUC of AFP for HCC diagnosis was the largest (0.827). The AUC of the combined groups was higher than the single groups of tumor markers; the AUC of the PCT+AFP+CA199+CA125 group was the highest in all combination groups, and AUC was 0.891. The verification of the best combination group showed that the AUC was 0.924 in the preoperative determined diagnosis group and 0.854 in the undetermined diagnosis group.
    Conclusion Tumor markers in combination with PLT and PCT can increase the preoperative differential diagnosis efficacy of HCC and ICC. The combination of PCT, AFP, CA199 and CA125 before operation is helpful to further determine the diagnosis and plan the operation scheme.

     

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