Clinical Value of Platelet and Its Parameters Combined with Tumor Markers in Preoperative Differentiation of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma

ZHANG Haodong; WEI Fengxian; ZHANG Chunfang; XU Xiaodong

doi:10.3971/j.issn.1000-8578.2022.21.0898

Cancer Research on Prevention and Treatment > 2022 > 49(3): 213-218. > DOI: 10.3971/j.issn.1000-8578.2022.21.0898

ZHANG Haodong, WEI Fengxian, ZHANG Chunfang, XU Xiaodong. Clinical Value of Platelet and Its Parameters Combined with Tumor Markers in Preoperative Differentiation of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma[J]. Cancer Research on Prevention and Treatment, 2022, 49(3): 213-218. DOI: 10.3971/j.issn.1000-8578.2022.21.0898

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Clinical Value of Platelet and Its Parameters Combined with Tumor Markers in Preoperative Differentiation of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma

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

Funding:

Lanzhou University Second Hospital "Cuiying Science and Technology Innovation" Plan CY2019-BJ02

Gansu Province Youth Science and Technology Fund Plan 21JR1RA161

More Information

Corresponding author:
XU Xiaodong, E-mail: 13893273850@163.com
Received Date: August 11, 2021
Revised Date: November 21, 2021
Available Online: January 12, 2024

Abstract

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.
- Hepatocellular carcinoma,
- Intrahepatic cholangiocarcinoma,
- Platelet,
- AFP,
- CA199,
- CA125,
- CEA

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Competing interests: The authors declare that they have no competing interests.

References (24)

References

[1]	Sia D, Villanueva A, Friedman SL, et al. Liver Cancer Cell of Origin, Molecular Class, and Effects on Patient Prognosis[J]. Gastroenterology, 2017, 152(4): 745-761. doi: 10.1053/j.gastro.2016.11.048
[2]	Massarweh NN, El-Serag HB. Epidemiology of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma[J]. Cancer Control, 2017, 24(3): 1073274817729245.
[3]	Brown KM, Parmar AD, Geller DA. Intrahepatic cholangiocarcinoma[J]. Surg Oncol Clin N Am, 2014, 23(2): 231-246. doi: 10.1016/j.soc.2013.10.004
[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. doi: 10.3760/cma.j.issn.1007-3418.2020.02.004 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. doi: 10.3760/cma.j.issn.1007-3418.2020.02.004
[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. https://www.cnki.com.cn/Article/CJFDTOTAL-ZPWZ201502007.htm 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. https://www.cnki.com.cn/Article/CJFDTOTAL-ZPWZ201502007.htm
[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. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYXX201707011.htm 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. https://www.cnki.com.cn/Article/CJFDTOTAL-ZYXX201707011.htm
[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. doi: 10.21037/hbsn.2017.01.06
[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, Iñarrairaegui 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. doi: 10.1002/hep.30319
[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. doi: 10.1038/nrgastro.2011.131
[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. https://www.cnki.com.cn/Article/CJFDTOTAL-WKLL202102012.htm 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. https://www.cnki.com.cn/Article/CJFDTOTAL-WKLL202102012.htm
[12]	Torre LA, Bray F, Siegel RL, et al. Global cancer statistics, 2012[J]. CA Cancer J Clin, 2015, 65(2): 87-108. doi: 10.3322/caac.21262
[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. doi: 10.1016/j.canlet.2015.09.008
[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. doi: 10.3969/j.issn.1674-5671.2021.02.03 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. doi: 10.3969/j.issn.1674-5671.2021.02.03
[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. doi: 10.1016/j.thromres.2014.08.008
[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. doi: 10.1016/j.thromres.2013.12.021
[17]	Nailin Li. Platelets in cancer metastasis: To help the "villain" to do evil[J]. Int J Cancer, 2016, 138(9): 2078-2087. doi: 10.1002/ijc.29847
[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. doi: 10.1016/j.ccell.2015.09.018
[19]	Nilsson RJ, Balaj L, Hulleman E, et al. Blood platelets contain tumor-derived RNA biomarkers[J]. Blood, 2011, 118(13): 3680-3683. doi: 10.1182/blood-2011-03-344408
[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. doi: 10.1177/0003319713520068
[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. doi: 10.1053/j.seminoncol.2014.04.007
[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. doi: 10.5603/GP.a2019.0045
[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. doi: 10.1016/j.jbo.2017.09.001
[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. doi: 10.3969/j.issn.1006-2084.2020.04.014 Dong CN, Zhai WP, Wang XY. Research progress in mechanism of platelet-mediated tumor cell growth and metastasis[J]. Yi Xue Zong Shu, 2020, 26(4): 695-699. doi: 10.3969/j.issn.1006-2084.2020.04.014

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[9]	LI Jian, ZHAO XI-wu, SHU Guo-rong, ZHANG Lan-shi, LI Long. The Value Of Measurement Of 4 Tumor Markers For Diagnosis And Evaluation Of Disease Extent In Patiets With Lung Cancer[J]. Cancer Research on Prevention and Treatment, 1999, 26(4): 278-280.
[10]	Ou yang Tao, Wang Tianfeng, Zhang Jingtai. Prognostic Impact of Pre-operative SeriumCEA in Breast Cancer Patients[J]. Cancer Research on Prevention and Treatment, 1999, 26(3): 193-194.

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Corresponding author: XU Xiaodong, 13893273850@163.com

1.
Department of General Surgery, Second Hospital of Lanzhou University, Lanzhou 730030, China

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Clinical Value of Platelet and Its Parameters Combined with Tumor Markers in Preoperative Differentiation of Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma