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炎症标志物对肝癌合并不同类型门静脉栓子的预测价值

周鹏鸽 卢高峰 任笑盈 张涛

引用本文:
Citation:

炎症标志物对肝癌合并不同类型门静脉栓子的预测价值

DOI: 10.3969/j.issn.1001-5256.2021.12.021
基金项目: 

河南省基础与前沿技术研究计划项目 (162300410128)

科技创新人才培育基金拔尖人才项目 (2020BJRCB01)

详细信息
    通信作者:

    卢高峰,lugaofeng78@163.com

  • 中图分类号: R735.7

Value of the inflammatory markers albumin, C-reactive protein, erythrocyte sedimentation rate, and interleukin-6 in predicting hepatocellular carcinoma with different types of portal vein thrombosis

Research funding: 

Basic and Frontier Technology Research Program of Henan Province (162300410128);

Top Talent Project of Scientific and Technological Innovation Talent Training Fund (2020BJRCB01)

  • 摘要:   目的  比较肝癌合并门静脉血栓(PVBT)与肝癌合并门静脉癌栓(PVTT)患者的生化及常规血液指标,探讨炎症指标在不同类型患者中的表达水平及临床意义。  方法  选取2016年1月—2020年12月于郑州大学第二附属医院诊治的肝癌合并PVBT患者51例(PVBT组),肝癌合并PVTT患者37例(PVTT组),随机选取同期住院的肝癌未合并门静脉栓子患者50例作为对照组。收集比较3组患者的一般临床资料、实验室检查结果等。计数资料组间比较采用χ2检验或Kruskal-Wallis秩和检验; 符合正态分布的计量资料组间比较采用单因素方差分析; 非正态分布的计量资料组间比较采用Kruskal-Wallis秩和检验。绘制ROC曲线评价Alb、CRP、ESR及IL-6在PVBT组与PVTT组的表达水平,计算ROC曲线下面积(AUC),分析各项指标对不同类型栓子的预测价值。  结果  3组一般资料及常规生化指标检查结果差异均无统计学意义(P值均>0.05),而炎症指标Alb、CRP、血沉(ESR)及IL-6在3组间差异均有统计学意义(H值分别为10.207、24.465、8.917、37.584,P值分别为0.006、<0.001、0.012、<0.001),进一步两组间比较提示,PVTT组Alb水平显著低于PVBT组与对照组,CRP、ESR及IL-6水平显著高于PVBT组与对照组,PVBT组CRP、IL-6水平显著高于对照组(P值均<0.05)。ROC曲线提示PVTT组Alb、CRP、ESR及IL-6的AUC分别为0.659、0.826、0.679、0.873,PVBT组AUC分别为0.508、0.635、0.503、0.701。  结论  在肝癌伴PVTT患者中炎症指标IL-6、CRP、ESR高表达,Alb低表达,且预测价值依次递减; 而在肝癌伴PVBT患者中IL-6、CRP、ESR表达相对较低,Alb表达较高,其中IL-6、CRP对PVBT有一定的预测价值,ESR、Alb的预测价值不高。

     

  • 图  1  Alb、CRP、ESR和IL-6预测不同类型门静脉栓子的ROC曲线

    注:由于Alb为负相关指标,故对其取倒数处理。

    表  1  3组患者一般资料比较

    指标 PVBT组(n=51) PVTT组(n=37) 对照组(n=50) 统计值 P
    男[例(%)] 32(62.7) 24(64.9) 30(60.0) χ2=0.221 0.896
    年龄(岁) 61.06±11.53 62.68±10.62 61.20±10.87 F=0.267 0.766
    病因[例(%)] χ2=0.323 0.851
      病毒性 39(76.5) 30(81.1) 40(80.0)
      非病毒性 12(23.5) 7(18.9) 10(20.0)
    Child-Pugh分级[例(%)] H=0.708 0.702
      A级 24(47.1) 18(48.6) 27(54.0)
      B级 16(31.4) 11(29.7) 15(30.0)
      C级 11(21.6) 8(21.6) 8(16.0)
    下载: 导出CSV

    表  2  3组实验室检查结果比较

    指标 PVBT组(n=51) PVTT组(n=37) 对照组(n=50) 统计值 P
    ALT(U/L) 56 (38~69) 49(35~72) 39(20~68) H=5.518 0.063
    AST(U/L) 82(60~98) 83(68~93) 84(52~94) H=0.532 0.767
    Alb(g/L) 33.2(31.0~36.0) 30.7(28.6~33.3)1) 34.9(29.7~38.3)2) H=10.207 0.006
    TBil(μmol/L) 27.3(17.6~38.5) 26.4(16.9~36.8) 25.5(16.8~32.1) H=0.429 0.807
    RBC(1012/L) 2.95(2.24~3.38) 3.13(2.42~3.64) 3.23(2.58~3.67) H=3.904 0.142
    PLT(109/L) 89(74~103) 94(84~109) 106(77~149) H=4.500 0.105
    WBC(109/L) 6.63(3.89~8.88) 7.16(4.93~9.16) 7.47(4.01~8.96) H=1.012 0.603
    NE% 71.0(64.0~83.6) 73.4(63.8~81.5) 67.9(59.5~80.6) H=1.085 0.581
    LY% 21.0(10.7~27.2) 20.0(12.5~28.5) 21.3(11.8~33.2) H=1.648 0.439
    MO% 6.02±2.46 5.76±2.41 5.55±2.13 F=0.267 0.604
    CRP(mg/L) 10.30(6.30~27.47) 22.80(12.67~33.52)1) 8.31(6.15~13.20)1)2) H=24.465 <0.001
    ESR(mm/h) 22(15~36) 31(24~49)1) 22(17~30)2) H=8.917 0.012
    IL-6(pg/ml) 7.61(4.64~14.88) 15.60(7.22~25.51)1) 4.28(2.81~7.06)1)2) H=37.584 <0.001
    注:与PVBT组比较,1)P<0.05;与PVTT组比较,2)P<0.05。
    下载: 导出CSV
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  • 收稿日期:  2021-05-11
  • 录用日期:  2021-06-02
  • 出版日期:  2021-12-20
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