Wang Han-Xuan, Li Yu-Lin, Huang Jin-Can, Ma You-Wei, Lang Ren, Lyu Shao-Cheng
Department of Hepatobiliary and Pancreaticosplenic Surgery, Beijing Chaoyang Hospital, Capital Medical University, Beijing 100020, China.
Diagnostics (Basel). 2023 Oct 4;13(19):3126. doi: 10.3390/diagnostics13193126.
Correctly distinguishing mass-forming chronic pancreatitis (MFCP) from pancreatic cancer (PC) is of clinical significance to determine optimal therapy and improve the prognosis of patients. According to research, inflammation status in PC is different from that in MFCP. Mean platelet volume/platelet ratio (MPR) is a platelet-related inflammation index which has been proven to be valuable in the diagnosis and prognosis of various malignant cancers due to the change in mean platelet volume and platelet count under abnormal inflammatory conditions caused by tumors. Thus, we conducted this study to investigate the clinical value of MPR in distinguishing MFCP from PC.
We retrospectively analyzed the data of 422 patients who were suspected to have PC during imaging examination at our department from January 2012 to December 2021. Included patients were divided into the PC ( = 383) and MFCP groups ( = 39), according to their pathological diagnosis. Clinical data including MPR were compared within these two groups and the diagnostic value was explored using logistic regression. The ROC curve between MPR and PC occurrence was drawn and an optimal cut-off value was obtained. Propensity score matching was applied to match MFCP patients with PC patients according to their age and carbohydrate antigen 19-9 (CA19-9). Differences in MPR between groups were compared to verify our findings.
The area under the ROC curve between MPR and PC occurrence was 0.728 (95%CI: 0.652-0.805) and the optimal cut-off value was 0.045 with a 69.2% sensitivity and 68.0% accuracy. For all the included patients, MPRs in the MFCP and PC groups were 0.04 (0.04, 0.06) and 0.06 (0.04, 0.07), respectively ( = 0.005). In patients with matching propensity scores, MPRs in the MFCP and PC groups were 0.04 (0.03, 0.06) and 0.06 (0.05, 0.08), respectively ( = 0.005). Multiple logistic regression in all included patients and matched patients confirmed MPR and CA19-9 as independent risk markers in distinguishing PC. Combining CA19-9 with MPR can increase the sensitivity and accuracy in diagnosing PC to 93.2% and 89.5%, respectively.
MPR in PC patients is significantly higher than that in MFCP patients and may be adopted as a potential indicator to distinguish MFCP and PC. Its differential diagnosis capacity can be improved if combined with CA19-9.
正确区分肿块型慢性胰腺炎（MFCP）和胰腺癌（PC）对于确定最佳治疗方案及改善患者预后具有临床意义。据研究，PC中的炎症状态与MFCP不同。平均血小板体积/血小板比率（MPR）是一种与血小板相关的炎症指标，由于肿瘤引起的异常炎症状态下平均血小板体积和血小板计数的变化，该指标已被证明在各种恶性肿瘤的诊断和预后中具有重要价值。因此，我们开展了本研究以探讨MPR在区分MFCP和PC方面的临床价值。
我们回顾性分析了2012年1月至2021年12月在我院影像检查时疑似患有PC的422例患者的数据。根据病理诊断，将纳入患者分为PC组（n = 383）和MFCP组（n = 39）。比较两组患者包括MPR在内的临床数据，并使用逻辑回归分析探讨其诊断价值。绘制MPR与PC发生之间的ROC曲线并获得最佳截断值。应用倾向评分匹配法根据年龄和糖类抗原19-9（CA19-9）将MFCP患者与PC患者进行匹配。比较组间MPR差异以验证我们的研究结果。
MPR与PC发生之间的ROC曲线下面积为0.728（95%CI：0.652 - 0.805），最佳截断值为0.045，灵敏度为69.2%，准确率为68.0%。对于所有纳入患者，MFCP组和PC组的MPR分别为0.04（0.04，0.06）和0.06（0.04，0.07）（P = 0.005）。在倾向评分匹配的患者中，MFCP组和PC组的MPR分别为0.04（0.03，0.06）和0.06（0.05，0.08）（P = 0.005）。对所有纳入患者和匹配患者进行的多元逻辑回归分析证实，MPR和CA19-9是区分PC的独立风险标志物。将CA19-9与MPR联合使用可将PC诊断的灵敏度和准确率分别提高到93.2%和89.5%。
PC患者的MPR显著高于MFCP患者，MPR可能作为区分MFCP和PC的潜在指标。与CA19-9联合使用可提高其鉴别诊断能力。
