摘要
目的探讨术前纤维蛋白原与白蛋白比值(FAR)和纤维蛋白原与前白蛋白比值(FPR)对胃癌的诊断价值。方法选取2016年1月至2020年1月于我院胃肠外科行胃癌根治术的患者457例(胃癌组),同时期于我院消化内科住院治疗的胃良性疾病患者448例(胃良性疾病组)和胃镜检查未见明显异常的体检者457名(健康对照组),比较三组患者的FPR、FAR、NLR、CEA、CA19-9水平,利用ROC曲线评价FPR、FAR、NLR、CEA、CA19-9对胃癌患者的诊断及良恶性患者的鉴别诊断;利用Logistic回归分析胃癌良恶性鉴别诊断的危险因素。通过Kruskal-Wallis、Mann-Whitney检验FPR、FAR、NLR与胃癌患者临床病理特征的相关性。结果胃癌组患者术前NLR、FPR、FAR、CEA、CA19-9均显著高于胃良性疾病组、健康对照组(P<0.001);FAR、NLR、CEA、CA19-9在胃良性疾病组与健康对照组相比,差异无统计学意义(P>0.05),而FPR在这两组中差异有统计学意义(P<0.05);通过Kruskal-Wallis、Mann-Whitney检验对胃癌患者临床病理特征分析显示,随着淋巴结转移、浸润深度加深、肿瘤最大直径增加、临床分期增加、分化程度降低,胃癌患者的FPR、FAR、NLR的中位数显著升高,而与肿瘤的位置无相关性。ROC曲线分析结果显示,FPR对胃癌的诊断效能显著高于其他指标。Logistic回归显示,FPR、NLR、CEA、CA19-9均与胃癌和胃良性疾病的鉴别诊断显著相关。在胃癌与胃良性疾病的鉴别诊断上,FPR与其他指标联合可提高诊断效能,其中FPR、NLR、CEA、CA19-9联合,ROC曲线下面积最大,有最大的诊断效能(AUC=0.768,灵敏度为70.4%,特异度为82.8%)。结论FPR可能是诊断胃癌有价值的生物标志物,其与NLR、CEA、CA19-9联合可显著提高胃癌和胃良性疾病的鉴别诊断效率。
Objective To investigate the diagnostic value of the fibrinogen to albumin ratio(FAR)and fibrinogen to pre-albumin ratio(FPR)in gastric cancer.Methods Totally 457 cases of gastric cancer(gastric cancer group)in our hospital from Jan.2016 to Jan.2020 were collected,and 448 patients with the same stage gastric benign diseases(gastric benign disease group)and 457 cases of normal healthly examiners(healthy control group)were selected.The levels of FPR,FAR,NLR,CEA,CA19-9 in the three groups were compared.The effectiveness of FPR,FAR,NLR,CEA,CA19-9 in the diagnosis of gastric cancer was analyzed by ROC curve.The risk factors of differential diagnosis in benign and malignant gastric lesions were analyzed by Logistic regression.Kruskal-Wallis and Mann-Whitney were used to test the correlation between FPR,FAR and NLR and clinicopathological characteristics of gastric cancer patients.Results NLR,FPR,FAR,CEA and CA19-9 in gastric cancer group were significantly higher than those in benign gastric disease group and healthy control group(P<0.001);there was no significant difference in FAR,NLR,CEA and CA19-9 between gastric benign disease group and healthy control group(P>0.05),however,there was a difference in FPR between the two groups(P<0.05).Kruskal-Wallis and Mann-Whitney test showed that the median of FPR,FAR and NLR in gastric cancer patients increased significantly with lymph node metastasis,depth of invasion,increase of tumor maximum diameter,increase of clinical stage and decrease of differentiation degree.ROC curve analysis showed that FPR was significantly higher than other indicators in the diagnosis of gastric cancer.Logistic regression showed that FPR,NLR,CEA and CA19-9 were significantly correlated with the differential diagnosis of gastric cancer and benign gastric diseases.In the differential diagnosis of gastric cancer and benign gastric diseases,FPR combined with other indicators could improve the diagnostic efficiency.Among them,FPR,NLR,CEA,CA19-9 had the largest area under the ROC curve,and had the largest diagnostic efficiency(AUC=0.768,sensitivity=70.4%,specificity=82.8%).Conclusion FPR is a valuable biomarker for the diagnosis of gastric cancer.The combination of FPR with NLR,CEA and CA19-9 can significantly improve the differential diagnosis efficiency of gastric cancer and benign gastric diseases.
作者
袁木发
刘欣
费素娟
YUAN Mufa;LIU Xin;FEI Sujuan(Department of Gastroenterology,the Affiliated Hospital of Xuzhou Medical University,Xuzhou 221002,China)
出处
《胃肠病学和肝病学杂志》
CAS
2021年第6期622-627,共6页
Chinese Journal of Gastroenterology and Hepatology
作者简介
第一作者:袁木发,在读硕士研究生,研究方向:消化道肿瘤。E-mail:2043599697@qq.com;通讯作者:费素娟,硕士,教授,研究方向:胃肠道黏膜损伤与修复。E-mail:xyfyfeisj99@163.com。
