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Clinical Value of Platelet and Its Parameters Combined with Tumor Markers in Preoperative Differentiation of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma |
ZHANG Haodong1, WEI Fengxian1, ZHANG Chunfang2, XU Xiaodong1 |
1. Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou 730030, China; 2. Department of Obstetrics, The Second Hospital of Lanzhou University, Lanzhou 730030, China |
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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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Keywords
Hepatocellular carcinoma
Intrahepatic cholangiocarcinoma
Platelet
AFP
CA199
CA125
CEA
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Fund:Lanzhou University Second Hospital “Cuiying Science and Technology Innovation” Plan (No. CY2019-BJ02); Gansu Province Youth Science and Technology Fund Plan (No. 21JR1RA161) |
Issue Date: 17 March 2022
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[1] Sia D, Villanueva A, Friedman SL, et al. Liver Cancer Cell of
Origin, Molecular Class, and Effects on Patient Prognosis[J]. Gast
roenterology, 2017, 152(4): 745-761.
[2] Massarweh NN, El-Serag HB. Epidemiology of Hepatocellular
Carcinoma and Intrahepatic Cholangiocarcinoma[J]. Cancer
Control, 2017, 24(3): 1073274817729245.
[ 3 ] Br own KM, P a rma r AD, Ge l l e r DA. I n t r a h e p a t i c
cholangiocarcinoma[J]. Surg Oncol Clin N Am, 2014, 23(2):
231-246.
[4] 中华人民共和国国家卫生健康委员会医政医管局. 原发性肝癌
诊疗规范(2019年版)[J]. 中华肝脏病杂志, 2020, 28(2): 112-128.
[Department of Medical Administration, National Health and
Health Commission of the People's Republic of China. Guidelines
for diagnosis and treatment of primary liver cancer in China
(2019 edition)[J]. Zhonghua Gan Zang Bing Za Zhi, 2020, 28(2):
112-128.]
[5] 杭轶, 杨小勇, 李文美. 肝内胆管癌与肝细胞癌临床特征的比
较研究[J]. 中国普通外科杂志, 2015, 24(2): 175-179. [Hang Y, Yang XY, Li WM. Comparative study of clinical features between
intrahepatic cholangiocarcinoma and hepatocellular carcinoma[J].
Zhongguo Pu Tong Wai Ke Za Zhi, 2015, 24(2): 175-179.]
[6] 陈丽华, 刘爱连, 宋清伟, 等. 磁共振扩散张量成像鉴别诊
断肝内胆管细胞癌与肝细胞癌[ J ] . 中国医学影像技术,
2017, 33(7): 993-997. [Chen LH, Liu AL, Song QW, et al.
Diffusion tensor imaging in differential diagnosis of intrahepatic
cholangiocarcinoma and hepatocellular carcinoma[J]. Zhongguo
Yi Xue Ying Xiang Ji Shu, 2017, 33(7): 993-997.]
[7] Wang K, Zhang H, Xia Y, Liu J, et al. Surgical options for
intrahepatic cholangiocarcinoma[J]. Hepatobiliary Surg Nutr,
2017, 6(2): 79-90.
[8] Macias RIR, Kornek M, Rodrigues PM, et al. Diagnostic and
prognostic biomarkers in cholangiocarcinoma[J]. Liver Int, 2019,
39 Suppl 1: 108-122.
[9] Banales JM, I?arrairaegui M, Arbelaiz A, et al. Serum Metabolites
as Diagnostic Biomarkers for Cholangiocarcinoma, Hepatocellular
Carcinoma, and Primary Sclerosing Cholangitis[J]. Hepatology,
2019, 70(2): 547-562.
[10] Blechacz B, Komuta M, Roskams T, et al. Clinical diagnosis and
staging of cholangiocarcinoma[J]. Nat Rev Gastroenterol Hepatol,
2011, 8(9): 512-522.
[11] 王冲, 程石. 肝内胆管癌—国内外专家共识及指南解读[J].
外科理论与实践, 2021, 26(2): 124-129. [Wang C, Cheng S.
Intrahepatic cholangiocarcinoma- consensus and guideline
interpretation of experts at home and abroad[J]. Wai Ke Li Lun Yu
Shi Jian, 2021, 26(2): 124-129.]
[12] Torre LA, Bray F, Siegel RL, et al. Global cancer statistics,
2012[J]. CA Cancer J Clin, 2015, 65(2): 87-108.
[13] Zhang H, Yang T, Wu M, et al. Intrahepatic cholangiocarcinoma:
Epidemiology, risk factors, diagnosis and surgical management[J].
Cancer Lett, 2016, 379(2): 198-205.
[14] 安澜, 冉显会, 郑荣寿, 等. 中国肝细胞癌和肝内胆管细胞癌
临床诊疗情况比较研究[J]. 中国癌症防治杂志, 2021, 13(2):
126-132. [An L, Ran XH, Zheng RS, et al. A comparative study
on clinical diagnosis and treatment of hepatocellular carcinoma
and intrahepatic cholangiocarcinoma in China[J]. Zhongguo Ai
Zheng Fang Zhi Za Zhi, 2021, 13(2): 126-132.]
[15] Chan TS, Hwang YY, Gill HS, et al. Increasing incidence of
venous thromboembolism due to cancer-associated thrombosis in
Hong Kong Chinese[J]. Throm Res, 2014, 134(5): 1157-1159.
[16] Walker AJ, Grainge MJ, Card TR, et al. Venous thromboembolism
in children with cancer-A population-based cohort study[J].
Throm Res, 2014, 133(3): 340-344.
[17] Nailin Li. Platelets in cancer metastasis: To help the “villain” to do
evil[J]. Int J Cancer, 2016, 138(9): 2078-2087.
[18] Best MG, Sol N, Kooi I, et al. RNA-Seq of tumor-educated
platelets enables blood-based pan-cancer, multiclass, and
molecular pathway cancer diagnostics[J]. Cancer Cell, 2015,
28(5): 666-676.
[19] Nilsson RJ, Balaj L, Hulleman E, et al. Blood platelets contain
tumor-derived RNA biomarkers[J]. Blood, 2011, 118(13):
3680-3683.
[20] Cetin M, Bakirci EM, Baysal E, et al. Increased platelet
distribution width is associated with ST-segment elevation
myocardial infarction and thrombolysis failure[J]. Angiology,
2014, 65(8): 737-743.
[21] Yan M, Lesyk G, Radziwon-Balicka A, et al. Pharmacological
Regulation of Platelet Factors That Influence Tumor
Angiogenesis[J]. Semin Oncol, 2014, 41(3): 370-377.
[22] Szubert S, Moszynski R, Szpurek D, et al. The expression
of Platelet-derived Growth factor receptors (PDGFRs) and
their correlation with overall survival of patients with ovarian
cancer[J]. Ginekol Pol, 2019, 90(5): 242-249.
[23] D’Oronzo S, Brown J, Coleman R. The role of biomarkers in the
management of bone-homing malignancies[J]. J Bone Oncol,
2017, 9: 1-9.
[24] 董超男, 翟文萍, 王雪野. 血小板介导肿瘤细胞生长和转移的
机制研究进展[J]. 医学综述, 2020, 26(4): 695-699. [Dong CN,
Zhai WP, Wang XY. Research progress in mechanism of plateletmediated
tumor cell growth and metastasis[J]. Yi Xue Zong Shu,
2020, 26(4): 695-699.]
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