术前FAR、CAR、LCR和CA19-9联合检测在胆囊癌诊断中的价值  

The Clinical Value of Preoperative Combined Detection of FAR,CAR,LCR and CA19-9 in the Diagnosis of Gallbladder Cancer

作　　者：冯家维 纪玥玥 沈瀚[1] 周万青[1] FENG Jiawei;JI Yueyue;SHEN Han;ZHOU Wanqing(Department of Clinical Laboratory,Nanjing Drum Tower Hospital,Affiliated Hospital of Medical School,Nanjing University,Nanjing 210008,China)

机构地区：[1]南京大学医学院附属鼓楼医院检验科,江苏南京210008

出　　处：《标记免疫分析与临床》2024年第12期2288-2292,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨纤维蛋白原-白蛋白比值(FAR)、C反应蛋白-白蛋白比值(CAR)、淋巴细胞-C反应蛋白比值(LCR)、糖类抗原19-9(CA19-9)联合分析在胆囊癌诊断中的价值。方法回顾性分析2021年1月至2024年2月在南京鼓楼医院就诊的102例胆囊癌初诊患者及80例胆囊息肉初诊患者的临床资料,比较两组人群FAR、CAR、LCR和CA19-9的水平,采用受试者工作特征(ROC)曲线评价单个指标及联合分析对胆囊良恶性肿瘤的鉴别诊断效能。同时分析各指标与胆囊癌TNM分期、淋巴结转移及远端转移的关系。结果胆囊癌组FAR、CAR、CA19-9水平均高于胆囊息肉组,而LCR水平低于对照组,差异均有统计学意义(P<0.05)。胆囊癌组III+IV期患者FAR、CAR、CA19-9水平高于I+II期患者,而LCR水平低于I+II期患者,差异具有统计学意义(P<0.05)。联合检测诊断胆囊癌的AUC(0.881)最大,灵敏度(77.50%)优于单项检测,特异性为96.30%。CA19-9与淋巴结转移相关(P<0.05),CAR、LCR则与远处转移相关(P<0.05)。结论FAR、CAR、LCR与CA19-9联合分析对胆囊癌的术前诊断、TNM分期以及评估进展情况均具有一定的临床意义,可为临床诊疗提供一定的参考价值。Objective To investigate the clinical value of combined analysis of fibrinogen-albumin ratio(FAR),C-reactive protein-albumin ratio(CAR),lymphocyte-C-reactive protein ratio(LCR) and carbohydrate antigen 19-9(CA19-9) in the diagnosis of gallbladder cancer.Methods The clinical data of 102 newly diagnosed patients with gallbladder cancer and 80 patients with newly diagnosed gallbladder polyps in Nanjing Drum Tower Hospital from January,2021 to February,2024 were retrospectively analyzed.Levels of FAR,CAR,LCR and CA19-9 in these two groups were compared.A joint diagnostic model was constructed,while the receiver operating characteristic(ROC) curve was drawn to evaluate the differential diagnosis efficacy of single index and combined analysis for benign and malignant gallbladder tumors.The relationship between each index and TNM stage,lymph node metastasis and distant metastasis of gallbladder cancer was then analyzed.Results Levels of FAR,CAR and CA19-9 in the gallbladder cancer group were significantly higher than those in the gallbladder polyp group,while LCR levels were significantly lower than those in the control group(P<0.05).Levels of FAR,CAR and CA19-9 in stage III+IV patients in the gallbladder cancer group were significantly higher than those in stage I+II patients,while LCR levels were significantly lower than those in stage I+II patients(P<0.05).AUC(0.881) and the sensitivity(77.50%) of the combined test for the diagnosis of gallbladder cancer were the highest,with the specificity of 96.30%.CA19-9 was associated with the presence or absence of lymph node metastasis(P<0.05),while CAR and LCR were associated with distant metastasis(P<0.05).Conclusion The combined analysis of FAR,CAR,LCR and CA19-9 has certain clinical significance for the preoperative diagnosis,TNM staging and the evaluation of progress of gallbladder cancer.This approach can provide useful reference value for clinical diagnosis and treatment.

关 键 词：纤维蛋白原-白蛋白比值 C反应蛋白-白蛋白比值 淋巴细胞-C反应蛋白比值 糖类抗原19-9 胆囊癌 

分 类 号：R735.8[医药卫生—肿瘤]