摘要
目的评估无创指标血小板/脾双径(PSR)预测乙型肝炎肝硬化肝癌患者食管静脉曲张的性能。方法回顾性分析上海东方肝胆外科医院255例肝癌术后患者的临床、腹部超声、内镜及病理资料,并计算PSR和天冬氨酸转氨酶/血小板比值(APRI)。结果胃镜检查发现,255例患者中129例(50.6%)有食管静脉曲张。多因素分析显示,血小板降低、脾肿大是食管静脉曲张出现的独立危险因素。通过受试者工作特征曲线下面积比较发现,PSR具有最好的诊断精确性(PSR:0.86,APRI:0.79,脾脏长径:0.77,血小板计数:0.75)。在临界值为931.0时,PSR对食管静脉曲张预测的敏感度为81.3%,特异度为80.1%,诊断精确度为80.8%。结论 PSR是预测乙型肝炎肝硬化肝癌患者有无静脉曲张的一个简单、无创、诊断精确性高的指标。
Objective To investigate the value of the platelet count/spleen bipolar diameter ratio（PSR）as a potential noninvasive predictor of esophageal varices（EVs）in patients with hepatitis B virus-related cirrhosis and potentially resectable liver tumors.Methods Two hundred and fifty-five patients with potentially resectable liver tumors were recruited in this retrospective study.PSR and APRI were calculated in all patients underwent comprehensive clinical examinations,biochemical tests,esophagogastroduodenoscopy and abdominal ultrasonography.Results EVs were detected in 129（50.6%）of the 255 patients with HCC through esophagogastroduodenoscopy.Multivariate analysis showed that lower platelet count and larger spleen diameter were independently associated with the presence of EVs.Receiver operating characteristic curves analysis showed that PSR had the most accurate diagnose for EVs（PSR0.86 vs.APRI 0.79,SD0.77 and PLT0.75）.At a cut-off value of 931.0.PSR at showed a sensitivity of 81.3%,a specificity of 80.1% and a correct patient classification rate of 80.8% in predicting the presence of EVs.Conclusion PSR is an accurate and noninvasive marker for predicting EVs so as to reduce unnecessary esophagogastroduodenoscopy.
出处
《肝脏》
2015年第8期597-601,共5页
Chinese Hepatology
基金
国家自然科学基金课题(81301724)
关键词
原发性肝癌
肝硬化
乙型肝炎
血小板/脾双径
食管静脉曲张
Hepatocellular carcinoma
Cirrhosis
Hepatitis B
Platelet number/ splenic bipolar diameter
Esophageal varice
