| Objective: To investigate the value of Platelet-to-lymphocyte Ratio(PLR)and Alkaline Phosphatase-to-lymphocyte Ratio(ALR)in the differential diagnosis and prediction of lymph node metastasis of intrahepatic cholangiocarcinoma,and to provide a reference for the early diagnosis and prediction of lymph node metastasis of intrahepatic cholangiocarcinoma.The results were used as a reference for the early diagnosis of intrahepatic cholangiocarcinoma and the prediction of lymph node metastasis in clinical practice.Methods: A retrospective analysis of 243 primary hepatocellular carcinoma patients who attended the Department of Gastroenterology and Department of Oncology of the Right River School of Ethnic Medicine from January 2016 to May 2022 was performed.General information was collected from the patients,and Lymphocyte(LYM)count,Neutrophils(NE)count,Platelet(PLT)count,Mononuclear(MNC)count,C-reactive protein(C-Reactive)count,and C-reactive protein(C-Reactive)count were measured,C-reactive Protein(CRP)count,Alkaline Phosphatase(ALP)count,Albumin(ALB)count,Aspartate Aminotransferase(AST)count,Neutrophil/Lymphocyte Ratio(NLR)C-reactive Protein/Albumin Ratio(CAR),Aspartate Aminotransferase(AST),Neutrophilto-lymphocyte Ratio(NLR),C-reactive Protein/Albumin Ratio(CAR),Aspartate-to-lymphocyte Ratio(CAR),and Aspartate Aminotransferase-to-platelet Ratio(CAR).Aminotransferase-to-Platelet Aatio Index(APRI),platelet/lymphocyte ratio,alkaline phosphatase/lymphocyte ratio and other venous blood indices were compared between groups using SPSS 26.0 statistical software.Results:(1)Comparing the general data of the intrahepatic cholangiocarcinoma group and the hepatocellular carcinoma group,we found that the age and lymph node metastasis rate of the intrahepatic cholangiocarcinoma group were higher than those of the hepatocellular carcinoma group,while the number of people with a history of alcohol consumption and the composition ratio of men were lower than those of the hepatocellular carcinoma group.(2)Comparison of blood test indexes between the intrahepatic cholangiocarcinoma group and the hepatocellular carcinoma group showed that the peripheral blood levels of NE,PLT,CRP,AST,ALP,NLR,CAR,PLR and ALR in the intrahepatic cholangiocarcinoma group were higher than those in the hepatocellular carcinoma group,while the levels of LYM,NE and ALB were lower than those in the hepatocellular carcinoma group(P<0.05).(3)The comparison of blood test indicators between intrahepatic cholangiocarcinoma with and without lymph node metastasis showed that the levels of PLR and ALR in the group with intrahepatic cholangiocarcinoma with lymph node metastasis were higher than those in the group without intrahepatic cholangiocarcinoma with lymph node metastasis,and the difference was statistically significant(P<0.05).(4)Correlation analysis of factors affecting intrahepatic cholangiocarcinoma revealed that LYM was a protective factor for the development of intrahepatic cholangiocarcinoma(OR<1,P<0.05),and PLT and ALP were risk factors for the development of intrahepatic cholangiocarcinoma(both OR>1,P<0.05).(5)PLR and ALR were risk factors for the development of intrahepatic cholangiocarcinoma(both OR>1,P<0.05)among the composite inflammatory indexes.(6)Correlation analysis of factors affecting intrahepatic cholangiocarcinoma with lymph node metastasis revealed that PLR and ALR were risk factors for lymph node metastasis of intrahepatic cholangiocarcinoma(both OR>1,P<0.05).(7)The area under the receiveroperatingcharacteristic(ROC)curve of PLT and ALP in the differential diagnosis of intrahepatic cholangiocarcinoma and hepatocellular carcinoma was 0.713 and 0.750 respectively,which were moderately efficient compared with 0.5,while the area under the LYM curve was 0.291,which had no diagnostic value compared with 0.5.The above indicators were statistically significant(P<0.05)compared to 0.5.(8)The area under the curve of PLR and ALR in the differential diagnosis of intrahepatic cholangiocarcinoma and hepatocellular carcinoma were 0.802 and 0.782 respectively,which were of moderate diagnostic efficiency compared with 0.5,and were statistically significant(P<0.05).(9)By comparison,in the differential diagnosis of intrahepatic cholangiocarcinoma and hepatocellular carcinoma,the area under the curve of PLR was the highest at 0.802,and its sensitivity and specificity were also higher at the optimal cut-off value of 0.777 and 0.746,respectively.(10)The area under the ROC curve of PLT and ALP in the prediction of lymph node metastasis in intrahepatic cholangiocarcinoma was 0.673 and 0.801,respectively,which were statistically significant compared with 0.5 The diagnostic efficiency was moderate and statistically significant compared to 0.5(P < 0.05).Conclusions:(1)The age composition,gender composition,smoking and drinking history and lymph node metastasis rate of patients with intrahepatic cholangiocarcinoma are different,which may provide a basis for the differential diagnosis of intrahepatic cholangiocarcinoma.(2)The elevation of PLR and ALR in patients with primary liver cancer may suggest intrahepatic cholangiocarcinoma,which has a certain potential to provide a reference for the differential diagnosis of intrahepatic cholangiocarcinoma and hepatocellular carcinoma.(3)The elevation of PLR and ALR in patients with intrahepatic cholangiocarcinoma can suggest the possibility of lymph node metastasis of cancer cells in patients with intrahepatic cholangiocarcinoma,which has a certain predictive value.In clinical practice,doctors performing PLR and ALR tests can provide a reference basis for the formulation of treatment plans for patients. |
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