Combination of CA19-9 and the neutrophil-to-lymphocyte ratio for the differential diagnosis of gallbladder carcinoma

Abstract

Purpose: This study aimed to evaluate the efficiency of several parameters, including the neutrophil-to-lymphocyte ratio (NLR) obtained from preoperative routine blood examina-tion, either alone or as an adjunct to the carbohydrate antigen 19-9 (CA19-9), for the diagnosis of gallbladder carcinoma (GBC). Patients and Methods: Data from 123 patients with gallbladder cholesterol polyps (GCP), 80 with gallbladder adenoma (GA), and 103 with GBC were reviewed retrospectively. Receiver operating characteristic analysis was used to assess the sensitivity, specificity, and clinical value of the NLR, CA19-9, and their combination. Results: Values of measured indicators were significantly higher in GBC patients than in GCP or GA patients but there were no significant differences between GCP and GA patients. The combination of NLR and CA19-9 had the best diagnostic efficiency for differentiating GBC from benign lesions with 74.8% sensitivity and 89.7% specificity. However, the NLR showed no significant difference between mid-to-advanced stage and early-to-mid stage GBC. The combination of NLR and CA19-9 (53.7% sensitivity and 88.9% specificity) did not reveal any advantages over CA19-9 alone (63.0% sensitivity and 89.0% specificity) in distinguishing different stages of GBC. Conclusion: NLR and CA19-9, and their combination―parameters that are easily obtained preoperatively―have potential as diagnostic markers for GBC.