| Objective: To observe and compare the different factors of ALBI,NLR and other factors on the differentiation of hepatocellular carcinoma(HCC),and to screen out the factors that have a positive judgment on the TCM syndrome differentiation of liver cancer,and evaluate its factors.The value of judging the differentiation of TCM syndrome differentiation.Methods:The cases included in this study were all untreated hepatocellular carcinoma patients admitted to the Affiliated Tumor Hospital of Guangxi Medical University from November 1st,2016 to October 31 st,2016.A total of 312 cases were collected,because 23 cases were not.According to the inclusion and exclusion criteria,289 patients with hepatocellular carcinoma who met the criteria were excluded.On the next morning,the hospital collected the first routine blood draw index(fasting),including blood routine,liver function,tumor markers,etc.At the same time,the full-time graduate students collected information on the patient’s four diagnoses,and detailed records,followed by two deputy high-level Chinese medicine practitioners According to the TCM classification criteria for syndrome differentiation;collect 20 factors that may have value in TCM syndrome differentiation of liver cell cancer(sex,age,history of hepatitis(hepatitis B and / or hepatitis C,hereinafter referred to as hepatitis),history of cirrhosis,Ascites,portal vein tumor thrombus,tumor number,tumor diameter,extrahepatic metastasis,BCLC stage,AFP,AST,ALT,ALB,TBIL,absolute neutrophil count,absolute lymphocyte count,PLT,ALBI(ALBI = 0.66 × Log10(Bilirubin)±(-0.085)×ALB),NLR(the ratio of the absolute value of neutrophils to the absolute value of lymphocytes);using SPSS22.0 statistical software,collating data and establishing a database → analysis of general data → screening positive Factors were analyzed by binary logistic regression analysis → ROC curve analysis of related factors.Results:(1)Results of general data:(1)289 cases of hepatocellular carcinoma patients with TCM syndrome types: 108 cases of wet heat accumulation type(37.37%),90 cases of qi stagnation and blood stasis type(31.14%),66 cases of liver stagnation and spleen deficiency type(22.84%),25 cases of liver and kidney yin deficiency(8.65%).(2)TCM type of liver cancer ALBI,NLR,BCLC stage,ALB,TBIL,ALT,AST,absolute neutrophil value,absolute lymphocyte value,ascites,portal vein tumor thrombus,extrahepatic metastasis,tumor diameter comparison,difference There was statistical significance(P<0.05),but there was no significant difference in gender,age,tumor number,history of hepatitis,history of liver cirrhosis,PLT and AFP(P>0.05).(2)Regression analysis of TCM syndrome types related to liver cancer: 1NLR,ALBI,BCLC staging,ALB,TBIL,ALT and TCM syndrome type of liver cancer were correlated(P<0.05),while AST,neutrophil absolute value,lymph Absolute cell value,ascites,portal vein tumor thrombus,extrahepatic metastasis,tumor diameter,etc.were not significantly associated with TCM syndromes of hepatocellular carcinoma(P>0.05).2NLR level increased,the risk of damp-heat accumulation type increased,ALBI level increased,the later the BCLC stage,the risk of liver-kidney yin deficiency type increased,the ALB level increased,the risk of liver stagnation and spleen-deficiency type increased,TBIL level Increased ALT levels have a reduced risk of qi stagnation and blood stasis.(3)The value of ROC curve analysis on the TCM syndrome type of liver cancer: NLR>3.165,ALBI>-1.8and BCLC stage in D stage,ALB>36.05g/L,clinical syndrome can be considered as damp heat accumulation type,liver and kidney yin deficiency type,liver stagnation and spleen deficiency type.When TBIL<28.45umol/L and ALT<78.5U/L,clinical dialectical can be considered as qi stagnation and blood stasis type.The areas under the ROC curve of ALBI,NLR,BCLC staging,ALB,TBIL,ALT and other indicators are between 50% and 70%.Conclusions:(1)289 cases of hepatocellular carcinoma patients with TCM syndrome type from high to low distribution followed by damp heat accumulation type > qi stagnation and blood stasis type > liver stagnation and spleen deficiency type > liver and kidney yin deficiency type.(2)ALBI,NLR,BCLC staging,ALB,TBIL,AST,ALT,absolute neutrophil count,absolute lymphocyte count,ascites,portal vein thrombosis,extrahepatic metastasis,hepatocellular carcinoma There were significant differences in tumor diameter,etc.,but there was no significant difference in gender,age,tumor number,history of hepatitis,history of liver cirrhosis,PLT,AFP,etc.(3)NLR,ALBI and BCLC staging,ALB are independent risk factors for liver cancer damp heat accumulation type,liver and kidney yin deficiency type,liver stagnation and spleen deficiency type.TBIL and ALT are protective factors of qi stagnation and blood stasis type.(4)NLR>3.165,ALBI>-1.80 and BCLC stage>3.5(ie belong to stage D),ALB>36.05g/L,TBIL<28.45umol/L and ALT<78.5U/L can be used as liver cancer damp heat accumulation Type,liver and kidney yin deficiency type,liver stagnation and spleen deficiency type,qi stagnation and blood stasis type of differentiation and judgment basis,but its judgment value is low. |
