NLR、CA19-9/GGT比值与肝细胞癌术前微血管侵犯的关系

Relationship between NLR,CA19-9/GGT ratio and preoperative microvascular invasion in hepatocellular carcinoma

目的:探讨中性粒细胞和淋巴细胞比值(NLR)、癌胚抗原19-9(CA19-9)/γ-谷氨酰转肽酶(GGT)比值与肝细胞癌(HCC)术前微血管侵犯(MVI)的关系。方法:回顾性选择2016年1月—2022年1月南京医科大学附属淮安第一医院收治的96例HCC患者,根据术后病理提示是否发生MVI将患者分为MVI组(55例)和非MVI组(41例)。收集患者人口学资料、术前超声影像学资料和实验室数据,术后病理资料,计算术前NLR以及CA19-9/GGT比值。多因素logistic回归分析NLR、CA19-9/GGT比值与HCC术前MVI的关系。绘制受试者工作特征曲线(ROC),分析NLR、CA19-9/GGT比值预测HCC患者术前发生MVI的价值。结果:MVI组肿瘤直径、NLR、CA19-9/GGT比值大于非MVI组(P<0.05),血流信号Ⅱ~Ⅲ级比例、Edmondson-Steiner分级Ⅲ~Ⅳ级比例,TNM分期Ⅲ~Ⅳ期比例,血管侵犯比例高于非MVI组(P<0.05),肿瘤数目多于非MVI组(P<0.05)。肿瘤直径、NLR、CA19-9/GGT是HCC患者术前发生MVI的危险因素(P<0.05)。联合NLR、CA19-9/GGT比值、肿瘤直径预测HCC患者术前发生MVI的曲线下面积为0.924,高于单独NLR、CA19-9/GGT比值、肿瘤直径的0.756、0.723、0.772(z=3.911、3.470、3.182,P<0.05)。结论:高NLR、CA19-9/GGT比值与HCC术前发生MVI有关,在HCC术前MVI预测中具有较高的价值。

Objective:To investigate the relationship between neutrophil/lymphocyte ratio(NLR),carcinoembryonic antigen 19-9(CA19-9)/gamma-glutamyl transpeptidase(GGT)ratio and microvascular invasion(MVI)before hepatocellular carcinoma(HCC).Methods:Clinical data of 96 HCC patients admitted to our hospital from January 2016 to January 2022 were retrospectively selected,and the patients were divided into MVI group(55 cases)and non-MVI group(41 cases)according to postoperative pathological findings.Demographic data,preoperative ultrasound imaging data,laboratory data,and postoperative pathological data were collected,and preoperative NLR and CA19-9/GGT ratio were calculated.The relationship between NLR,CA19-9/GGT ratio and MVI before HCC was analyzed by multivariate logistic regression analysis.Receiver operating characteristic curve(ROC)was drawn to analyze the value of NLR and CA19-9/GGT ratio in predicting the occurrence of preoperative MVI in HCC patients.Results:Tumor diameter,NLR and CA19-9/GGT ratio in MVI group were higher than those in non-MVI group(P<0.05),the proportion of blood flow signal gradeⅡtoⅢ,Edmondson-Steiner gradeⅢtoⅣ,TNM stageⅢtoⅣ,and the proportion of vascular invasion were higher than those in non-MVI group(P<0.05).The number of tumor was higher than that of non-MVI group(P<0.05).Tumor diameter,NLR and CA19-9/GGT were risk factors for preoperative MVI in HCC patients(P<0.05).The area under the curve for predicting preoperative MVI in HCC patients by combining NLR and CA19-9/GGT ratio was 0.924,which was higher than 0.756,0.723 and 0.772 of NLR,CA19-9/GGT ratio and tumor diameter alone(z=3.911,3.470,3.182;P<0.05).Conclusion:High NLR and CA19-9/GGT ratio are associated with the occurrence of MVI before HCC,and have high value in the prediction of MVI before HCC.