Siddeek Rohik Anjum T, Gupta Amit, Gupta Sweety, Goyal Bela, Gupta Arvind Kumar, Agrawal Saumya, Roshan Ravi, Kumar Utkarsh, Kumar Navin, Gupta Manoj, Kishore Sanjeev, Kant Ravi
Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
J Carcinog. 2020 Jun 27;19:5. doi: 10.4103/jcar.JCar_12_20. eCollection 2020.
Gall bladder cancer (GBC) tends to present in advanced stages, therefore, early diagnosis of GBC is necessary. There is no ideal single tumor marker available presently for the diagnosis and prognosis of GBC. Platelet distribution width (PDW) is an early marker for activated platelets and has been used in a variety of tumors to assess prognosis. This study was designed to evaluate the utility of PDW in identifying GBC patients and its association with tumor markers, staging and resectability of GBC.
This cross sectional study was done on 100 patients of GBC and 100 age- and sex- matched healthy controls. PDW was evaluated and compared between GBC and healthy controls. Receiver-operating characteristics was plotted to determine optimal cut-off for identifying GBC patients and to determine sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of PDW. Correlation between serum tumor markers (carbohydrate antigen 19-9, carcinoembryonic antigen, and carbohydrate antigen 125) and PDW were evaluated. Association of PDW with hyperbilirubinemia, staging and resectability of GBC was also studied.
A significantly higher PDW with a median of 18.1 was observed in GBC as compared to healthy controls with median value of 13. PDW was found to have a very high sensitivity (90%), specificity (95%), PPV (94%) and NPV (90%) in identifying GBC at cut-off of 16 with area under the curve (AUC) of 0.97. An increase of PDW was observed with increasing stage and unresectable GBC. However, it was not statistically significant. Significant positive correlation was observed between PDW and all three serum tumor markers and good positive correlation with = 0.61 was observed with CA 19-9.
PDW was associated with GBC and may be considered as a cost- effective marker in adjunct to other investigations for the diagnosis of GBC.
胆囊癌（GBC）往往在晚期才出现，因此，胆囊癌的早期诊断很有必要。目前尚无理想的单一肿瘤标志物可用于胆囊癌的诊断和预后评估。血小板分布宽度（PDW）是活化血小板的早期标志物，已被用于多种肿瘤的预后评估。本研究旨在评估PDW在识别胆囊癌患者中的效用及其与肿瘤标志物、胆囊癌分期和可切除性的关系。
本横断面研究对100例胆囊癌患者和100例年龄及性别匹配的健康对照者进行。评估并比较胆囊癌患者和健康对照者的PDW。绘制受试者工作特征曲线以确定识别胆囊癌患者的最佳临界值，并确定PDW的敏感性、特异性、阳性预测值（PPV）和阴性预测值（NPV）。评估血清肿瘤标志物（糖类抗原19-9、癌胚抗原和糖类抗原125）与PDW之间的相关性。还研究了PDW与高胆红素血症、胆囊癌分期和可切除性的关系。
与健康对照者（中位数为13）相比，胆囊癌患者的PDW显著更高，中位数为18.1。在临界值为16时，PDW在识别胆囊癌方面具有很高的敏感性（90%）、特异性（95%）、PPV（94%）和NPV（90%），曲线下面积（AUC）为0.97。随着胆囊癌分期增加和不可切除性增加，PDW升高，但差异无统计学意义。PDW与所有三种血清肿瘤标志物之间均存在显著正相关，与CA 19-9的相关性良好，r = 0.61。
PDW与胆囊癌相关，可作为一种经济有效的标志物，辅助其他检查用于胆囊癌的诊断。
