Zhang Yan, Wu Jing, Cui Huaizhong, Zhang Xiaojing, He Lingyan, Gu Kailong, Xu Aifang
Department of Clinical Laboratory, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China.
Department of hepatology, Hangzhou Xixi Hospital, Hangzhou Sixth People's Hospital, Hangzhou Xixi Hospital Affiliated to Zhejiang Chinese Medical University, Hangzhou, Zhejiang, People's Republic of China.
Onco Targets Ther. 2025 Aug 11;18:865-872. doi: 10.2147/OTT.S527224. eCollection 2025.
Liver cancer ranks among the most prevalent and lethal malignancies worldwide, with metastatic malignant ascites being a common complication. This study seeks to assess the diagnostic significance of high fluorescent cells (HFCs), biochemical and tumor markers in predicting the development of metastatic malignant ascites in patients with liver cancer.
We collected ascites samples from 266 patients diagnosed with liver cancer. HFC were analyzed using the BF mode of the BC-7500 hematology analyzer, assessing both relative counts (HF-BF%) and absolute counts (HF-BF#). Additionally, biochemical and tumor markers were evaluated in serum and ascites. The diagnostic accuracy of these indicators, both individually and in combination, was assessed using receiver operating characteristic (ROC) curve analysis.
The malignant ascites group exhibited significantly higher levels of HF-BF%, cancer ratio 2 (Ratio2, ascites LDH: ascites ADA Ratio), and neuron-specific enolase (NSE) compared to the benign group, identifying these markers as independent risk factors for malignant ascites in liver cancer patients. Ratio2 demonstrated limited diagnostic value for malignant ascites, with an area under the curve (AUC) of 0.614. In contrast, HF-BF% and NSE showed moderate diagnostic capabilities, with AUCs of 0.760 and 0.700, respectively. The combined assessment of all three indicators yielded a high diagnostic capability, with an AUC of 0.824. The critical values for NSE, HF-BF%, and Ratio2 were 11.42 U/mL, 4.35/100 WBC, and 32.82%, respectively.
The combined evaluation of HF-BF%, Ratio2, and NSE serves as a valuable indicator for predicting the occurrence of metastatic malignant ascites in liver cancer patients.
肝癌是全球最常见且致命的恶性肿瘤之一，转移性恶性腹水是常见并发症。本研究旨在评估高荧光细胞（HFC）、生化指标及肿瘤标志物在预测肝癌患者转移性恶性腹水发生中的诊断意义。
我们收集了266例肝癌患者的腹水样本。使用BC - 7500血液分析仪的BF模式分析HFC，评估相对计数（HF - BF%）和绝对计数（HF - BF#）。此外，还评估了血清和腹水中的生化指标及肿瘤标志物。使用受试者工作特征（ROC）曲线分析评估这些指标单独及联合使用时的诊断准确性。
与良性腹水组相比，恶性腹水组的HF - BF%、癌比值2（Ratio2，腹水乳酸脱氢酶：腹水腺苷脱氨酶比值）和神经元特异性烯醇化酶（NSE）水平显著更高，表明这些标志物是肝癌患者发生恶性腹水的独立危险因素。Ratio2对恶性腹水的诊断价值有限，曲线下面积（AUC）为0.614。相比之下，HF - BF%和NSE具有中等诊断能力，AUC分别为0.760和0.700。三项指标联合评估具有较高诊断能力，AUC为0.824。NSE、HF - BF%和Ratio2的临界值分别为11.42 U/mL、4.35/100白细胞和32.82%。
HF - BF%、Ratio2和NSE联合评估是预测肝癌患者发生转移性恶性腹水的有价值指标。
