To Explore The Clinical Application Value Of SF,NLR And PLR In Differentiating Primary Liver Cancer And Hepatic Alveolar Echinococcosis

Objective: To explore the clinical application value of SF,NLR and PLR in differentiating primary liver cancer from hepatic alveolar echinococcosis.Methods: The clinical data of primary liver cancer and hepatic alveolar echinococcosis admitted to the Department of Hepatobiliary and Pancreatic Surgery of Qinghai University Affiliated Hospital from January 2015 to December 2019 were retrospectively analyzed,and the single-factor t test was used to compare the peripheral blood PLR,Whether there is a difference in the levels of NLR and SF and related indicators,the single factor and multivariate logistics regression methods are used to analyze the correlation between SF,NLR,PLR and hepatic alveolar echinococcosis and primary liver cancer.The meaningful indicators in the results of the multivariate analysis were evaluated by receiver operating characteristic curve(ROC curve)to evaluate their distinguishing power in the two diseases,and a calibration curve was drawn to compare the distinguishing power.Finally,evaluate the diagnostic value of the optimal plan for AFP-negative PHC patients.Results: After screening by the inclusion and exclusion criteria,this study included 324 patients,including 136 patients with hepatic alveolar echinococcosis,188 patients with primary liver cancer(45 of which were AFP negative,accounting for23.93%),and 141 males Cases(43.5%),183 female cases(56.5%),the age ranged from7 to 77 years old,with an average of(47.9±14.1)years old.The single factor t test was used to analyze the relationship between the indicators in the hepatic alveolar echinococcosis group and the primary liver cancer group.The results showed that SF,PLR,lymphocytes,platelets,WBC,AST,and ALT were significantly different between the two groups.The differences were statistically significant(all P<0.05).The levels of SF,AST,and ALT in the PHC group were higher than those in the hepatic alveolar echinococcosis group,and the levels of PLR,lymphocytes,platelets,and WBC in the HAE group were higher than those in the PHC group;Factors and multivariate logistics analysis results show that SF and PLR can be used as independent indicators to distinguish PHC and HAE(P<0.05);receiver operating characteristic curve(ROC curve)is used to evaluate SF,PLR and SF combined with PLR in the identification of liver alveoli The efficacy of echinococcosis group and primary liver cancer group was found that the area under the ROC curve of SF was AUC=0.651(95%CI: 0.591~0.712,P<0.0001),and the area under the ROC curve of PLR was AUC=0.823(95%CI:0.778~0.868,P<0.0001),the area under the ROC curve of SF combined with PLR is AUC=0.844(95%CI: 0.800~0.887,P<0.0001),suggesting that combining the two indicators can effectively improve both Differential efficacy of group diseases.Using R language to draw the calibration curve of the three schemes,SF combined with PLR has the best identification effect;the patients with AFP-negative liver cancer are included in the model and the ROC curve is drawn for verification and evaluation.The area under the ROC curve is 0.903,which indicates that the combined diagnosis scheme is for AFP-negative primary Hepatocellular carcinoma and hepatic alveolar echinococcosis have a good discrimination efficiency;comprehensive comparison of the three groups of discrimination schemes,the combined diagnosis scheme is the optimal discrimination scheme.Conclusion: The two indicators of SF and PLR have significance in the differential diagnosis of PHC and HAE,and there is no significant difference in NLR;the combination of the two can improve the efficiency of distinguishing the two diseases.