关键词: 原发性肝癌, FIB/PT, AFP, 诊断, 血清标志物

Abstract: Objective The aim of this study was to explore the diagnostic value of fibrinogen to prothrombin time ratio (FIB/PT) for patients with primary liver cancer. Methods The clinical data of patients with liver cirrhosis (n=168) and liver cancer (n=175) were collected in the Central Hospital of Suizhou (Suizhou Hospital Affiliated to Hubei University of Medicine) from July 2018 to July 2022. The differences in demography and clinical characteristics between the two groups were compared. And the variables with independent diagnostic value for liver cancer were selected by Logistic regression analysis. The above samples were randomly divided into a training group (n=232) and a validation group (n=111). The differences in the patient constituent ratio, age, gender, fibrinogen (FIB), prothrombin time (PT), FIB/PT, and alpha-fetoprotein (AFP) between the two groups were compared. The receiver operating characteristic (ROC) curve analysis was used to evaluate the diagnostic value of FIB/PT and AFP for liver cancer. Results There were significant differences in gender, age, FIB, PT, FIB/PT, and AFP levels between the liver cirrhosis and liver cancer groups (P<0.05). Single factor logistic regression analysis showed that age, gender, FIB, PT, FIB/PT, and AFP were all risk factors associated with liver cancer from simply cirrhosis (P<0.05), with OR (95% CI) of 1.021 (1.000~1.041),1.842 (1.157~2.932),1.014 (1.011~1.017), 0.597 (0.523~0.683), 1.172 (1.132~1.212), and 1.005 (1.003~1.007), respectively; multivariate logistic regression analysis showed that age, FIB/PT, and AFP were independent risk factors associated with liver cancer (P<0.05), with OR (95%CI) of 1.036 (1.005~1.068), 1.199 (1.148~1.253), and 1.004 (1.006~1.008), respectively. There was no significant difference in patient constituent ratio, age, gender, FIB, PT, FIB/PT, and AFP between the training group and the validation group (P>0.05).The Receiver operating characteristic (ROC) curve analysis showed that the area under the ROC (AUROC) (95%CI) of FIB/PT in the training group and the validation group were 0.829 (0.776~0.881) and 0.892 (0.834~0.950) respectively, those of AFP were 0.776 (0.714~0.839) and 0.752 (0.660~0.844) respectively. The sensitivity of FIB/PT was 74.6% and 78.9% respectively, and those of AFP was 53.4% and 50.9% respectively. The specificity of FIB/PT was 77.2% and 83.3% respectively, and those of AFP was 95.6% and 94.4%, respectively. The accuracy of FIB/PT was 75.9% and 81.1%, and those of AFP was 74.1% and 72.1%, respectively. Conclusion FIB/PT shown good diagnostic value for liver cancer in these cohorts, which is comparable or even superior to AFP.    

Key words: Primary liver cancer, FIB/PT, AFP, Diagnosis, Serum marker