AAPR、NLR、CAR与原发性肝癌肿瘤包膜侵犯、Ki67指数的相关性及对疾病预后的评估价值  

Correlation of AAPR,NLR and CAR with tumor capsule invasion and Ki67 index in primary hepatocellular carcinoma and their evaluation value for disease prognosis

作　　者：沈丹凤 汤晨雪 SHEN Danfeng;TANG Chenxue(Department of Clinical Laboratory,Nantong Tumor Hospital,Nantong,Jiangsu 226361,China;Department of Clinical Laboratory,Affiliated Hospital of Nantong University,Nantong,Jiangsu 226361,China)

机构地区：[1]南通市肿瘤医院检验科,江苏南通226361 [2]南通大学附属医院检验科,江苏南通226361

出　　处：《国际检验医学杂志》2023年第7期862-865,共4页International Journal of Laboratory Medicine

摘　　要：目的探究外周血清蛋白/碱性磷酸酶比值(AAPR)、中性粒细胞与淋巴细胞比值(NLR)、C反应蛋白/清蛋白比值(CAR)在原发性肝癌患者中的水平,并分析其与包膜侵犯、Ki67指数的相关性及对疾病预后的评估价值。方法选取于南通市肿瘤医院2020—2021年就诊的96例原发性肝癌患者作为研究对象,根据患者是否发生包膜侵犯和Ki67指数进行了分组,分别应用免疫组织化学法对Ki67指数进行检测,运用病理学检查明确是否发生包膜侵犯,采用自动生化分析仪检测并计算AAPR、NLR、CAR,并进行相关性分析和受试者工作特征(ROC)曲线分析。结果相较于未发生包膜侵犯患者和Ki67指数低的患者,发生包膜侵犯的患者和Ki67指数高的患者AAPR水平较低(P<0.05),NLR、CAR较高(P<0.05)。患者包膜侵犯的发生和Ki67指数与AAPR呈负相关(r<0,P<0.05),与NLR、CAR呈正相关(r>0,P<0.05)。随访6个月后死亡的患者AAPR低于生存患者(P<0.05),NLR、CAR高于生存患者(P<0.05)。ROC曲线分析可知,AAPR、NLR、CAR对患者预后有较高的预测价值,其联合预测效能最佳。结论原发性肝癌患者包膜侵犯的发生和Ki67指数与AAPR呈负相关,与NLR、CAR呈正相关,这3种指标对于患者预后有较高的预测价值,且联合预测效能最佳。Objective To explore the albumin-to-alkaline phosphatase ratio(AAPR),neutrophil-to-lymphocyte ratio(NLR)and C-reactive protein-to-albumin ratio(CAR)in patients with primary hepatocellular carcinoma,and analyze their correlation with capsule invasion,Ki67 index and to analyze their value in evaluating disease prognosis.Methods A total of 96 patients with primary hepatocellular carcinoma who were treated in Nantong Tumor Hospital from 2020 to 2021 were selected as the research objects.They were grouped according to whether the patients had capsule invasion and the value of Ki67 index.The Ki67 index was detected by immunohistochemistry,and the presence of capsule invasion was confirmed by pathological examination.The AAPR,NLR and CAR were detected and calculated by automatic biochemical analyzer,and correlation analysis and receiver operating characteristic(ROC)curve analysis were carried out.Results Patients with capsule invasion and those with high Ki67 index had decreased AAPR value and elevated NLR and CAR values compared with non-invasive patients and those with low Ki67 index(P<0.05).The presence of capsule invasion and the value of Ki67 index had a negative correlation with AAPR(r<0,P<0.05),and a positive correlation with NLR and CAR(r>0,P<0.05).The AAPR of patients who died during the 6 months of follow-up was lower than that of living patients(P<0.05),and the NLR and CAR were higher than those of living patients(P<0.05).ROC curve analysis denoted that AAPR,NLR and CAR were of great predictive value for the evaluation of the prognosis of patients,and the combined detection of the three had the highest predictive efficacy.Conclusion The presence of capsule invasion and the value of Ki67 index in patients with primary hepatocellular carcinoma are negatively correlated with AAPR,and positively correlated with NLR and CAR values.These three indicators have high prognostic value for patients,and predictive efficacy of combined detection is the best.

关 键 词：外周血清蛋白/碱性磷酸酶比值 中性粒细胞与淋巴细胞比值 C反应蛋白/清蛋白比值 包膜侵犯 Ki67指数 

分 类 号：R446.1[医药卫生—诊断学]