摘要
目的分析系统性免疫性炎症指数(SII)、外周血中性粒细胞和淋巴细胞比值(NLR)、血小板和淋巴细胞比值(PLR)分别在分化型甲状腺癌(DTC)和甲状腺良性结节中的差异,研究SII、NLR、PLR在甲状腺良、恶性结节鉴别诊断中的价值。方法回顾性分析2014年6月—2017年12月于中国人民武装警察部队特色医学中心经手术治疗的甲状腺结节病人临床资料,根据术后病理结果将其分为DTC组和良性结节组,分别讨论SII、NLR、PLR在2组之间的差异。应用受试者操作特征曲线(ROC)分析鉴别甲状腺良、恶性结节的最佳cut-off值。结果DTC组SII、NLR显著高于甲状腺良性结节组,差异有统计学意义(P<0.01)。2组PLR对比差异无统计学意义(P>0.05)。由ROC曲线分析得出鉴别甲状腺良、恶性结节的SII的最佳cut-off值为520.65,敏感度为41.6%,特异度为87.0%,阳性预测值为70.0%,阴性预测值为64.8%,曲线下面积(AUC)为0.659。鉴别甲状腺良、恶性结节的NLR的最佳cut-off值为1.81,敏感度为62.4%,特异度为83.9%,阳性预测值为74.5%,阴性预测值为73.4%,AUC为0.720。结论术前高SII、NLR对DTC有一定诊断价值,临床工作中,可使用术前SII、NLR指导甲状腺良、恶性的鉴别诊断,为甲状腺结节患者的全面评估提供重要参考。
Objective By analyzing the differences of systemic immune-inflammation index(SII),neutrophil-to-lymphocyte ratio(NLR)and platelet-to-lymphocyte ratio(PLR)between patients of differentiated thyroid cancer(DTC)and benign thyroid nodules,aimed at evaluating the diagnostic value of SII,NLR and PLR in differential diagnoses of benign and malignant thyroid nodules.Methods A retrospective study was performed to analyze the clinical data of patients with thyroid nodules who accepted surgery treatment for the first time in the Characteristic Medical Center of Chinese People’s Armed Police Forces from June 2014 to December2017.The patients were divided into a benign nodules group and DTC group according to postoperative pathological results.The differences of SII,NLR and PLR between the two groups were discussed.Furthermore,the optimal cut-off value of SII and NLR to discriminate between benign and malignant nodules of thyroid was obtained via the receiver operator characteristic curve(ROC).Results SII and NLR were significantly different between the two groups(P<0.01).PLR was no significantly different(P>0.05).The optimal SII cut-off point obtained from ROC analysis was 520.65(sensitivity 41.6%,specificity 87.0%,positive predict value 70.0%,negative predict value 64.8%),while area under curve(AUC)was 0.659.The optimal NLR cutoff point obtained from ROC analysis was 1.81(sensitivity 62.4%,specificity 83.9%,positive predict value74.5%,negative predict value 73.4%),while AUC was 0.720.Conclusion Preoperative higher SII and NLR values have certain diagnostic value for DTC.In clinical work,preoperative SII and NLR values can be used to guide the differential diagnosis of benign and malignant thyroid nodules,provide an important reference for a comprehensive assessment of thyroid nodules.
作者
赵跃
郭永刚
孙甲甲
刘春蓉
周广磊
黄景昊
王宁
吴凤云
Zhao Yue;Guo Yong-gang;Sun Jia-jia;Liu Chun-rong;Zhou Guang-lei;Huang Jing-Hao;Wang Ning;Wu Feng-yun(Department of Thyroid and Breast Surgery,Characteristic Medical Center of Chinese People's Armed Police Forces,Tianjin 300162,China;Soldier Team 5,Logistics University of Chinese People's Armed Police Forces,Tianjin 300309,China;Department of Pathology,Logistics University of Chinese People's Armed Police Forces,Tianjin 300309,China)
出处
《兰州大学学报（医学版）》
CAS
2018年第6期50-56,共7页
Journal of Lanzhou University（Medical Sciences）
基金
国家自然科学基金项目(81302577).
