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Lingual flange protrusion: diagnostic marker for metastatic liver cancer
Yinlu Ma1,2,3,4, Cuihong Zhu1,2,3,4, Rui Tianjin Medical University Cancer Institute And Hospital Cao
1Tianjin Medical University Cancer Institute and Hospital, Tianjin 300060, China National Clinical Research Center for Cancer.
Objective:
To investigate the diagnostic significance of lingual flange protrusion for liver metastasis of patients with malignant neoplasia.
Methods:
The data of 191 patients with malignant neoplasia were analyzed. All photos of patients' tongue image were recorded and lingual flange protrusion was the positive standard. χ2 test for paired data and Kappa test were used to determine the diagnostic value of lingual flange protrusion for metastatic liver cancer. Mann-Whitney U test was used to compare the levels of liver serological markers. The area under receiver operating characteristic curve (ROC) and logistic regression model were used to analyze the predictive values of lingual flange protrusion, alkaline phosphatase (ALP), and lactate dehydrogenase (LDH) levels.
Results:
Patients with lingual flange protrusion had a higher risk of liver metastasis than those without it (P < 0.001). There was no significant difference in diagnosis of liver metastasis between lingual flange protrusion and traditional diagnostic criteria (P = 0.541). Kappa was 0.738 (P < 0.001). Lingual flange protrusion was significantly correlated with increased serum ALP and LDH levels (P < 0.01). Comparison of ROC curves showed that the diagnostic value of lingual flange protrusion is better than ALP, LDH and the combination of ALP and LDH (P < 0.01). Furthermore, the combined diagnostic values of lingual flange protrusion and ALP, lingual flange protrusion and LDH, and lingual flange protrusion, ALP and LDH are not better than lingual flange protrusion alone (P > 0.05).
Conclusion:
Lingual flange protrusion is a potential diagnostic marker for liver metastasis of patients with malignant neoplasia.

