炎症标志物对肝癌合并不同类型门静脉栓子的预测价值  

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

作　　者：周鹏鸽 卢高峰[1] 任笑盈 张涛 ZHOU Pengge;LU Gaofeng;REN Xiaoying;ZHANG Tao(Department of Gastroenterology,The Second Affiliated Hospital of Zhengzhou University,Zhengzhou 450014,China)

机构地区：[1]郑州大学第二附属医院消化内科,郑州450014

出　　处：《临床肝胆病杂志》2021年第12期2838-2842,共5页Journal of Clinical Hepatology

基　　金：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)。

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χ^(2)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。Objective To investigate the biochemical and routine blood parameters in hepatocellular carcinoma(HCC)patients with portal vein blood thrombus(PVBT)or portal vein tumor thrombosis(PVTT),as well as the expression level and clinical significance of inflammatory indices in patients with different types of PVBT.Methods A total of 51 HCC patients with PVBT and 37 HCC patients with PVTT who were diagnosed and treated in The Second Affiliated Hospital of Zhengzhou University from January 2016 to December 2020 were enrolled as PVBT group and PVTT group,respectively,and 50 HCC patients without portal vein thrombosis who were hospitalized during the same period of time were enrolled as control group.General clinical data and laboratory test results were collected from the three groups.The chi-square test or the Kruskal-Wallis rank sum test was used for comparison of categorical data between groups;a one-way analysis of variance was used for comparison of normally distributed continuous data between groups,and the Kruskal-Wallis rank sum test was used for comparison of non-normally distributed continuous data between groups.The receiver operating characteristic(ROC)curve was plotted to investigate the expression levels of albumin(Alb),C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),and interleukin-6(IL-6)in the PVBT group and the PVTT group,and the area under the ROC curve(AUC)was calculated to analyze their value in predicting different types of thrombosis.Results There were no significant differences in general data and conventional biochemical parameters between the three groups(all P>0.05),while there were significant differences in the inflammatory indices Alb,CRP,ESR,and IL-6 between the three groups(H=10.207,24.465,8.917,and 37.584,P=0.006,P<0.001,P=0.012,and P<0.001),and further analysis between two groups showed that the PVTT group had a significantly lower level of Alb and significantly higher levels of CRP,ESR,and IL-6 than the PVBT group and the control group,and the PVBT group had significantly high

关 键 词：癌 肝细胞 静脉血栓栓塞 炎症标志物 

分 类 号：R735.7[医药卫生—肿瘤]