Abstract: 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. χ~2 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 serolog-ical 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.

Key words: Liver neoplasms, Tongue inspection, Lingual flange protrusion, Alkaline phosphatase, Lactate dehydrogenases, Gamma-glutamyltransferase