摘要
目的探索中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)及癌胚抗原在胃良恶性疾病诊断及鉴别诊断中的临床价值及意义。方法回顾性分析2013年1月至2018年1月在本院收治的216例的胃恶性肿瘤及212例胃良性疾病患者临床资料,对其血常规、癌胚抗原进行检测分析,同时利用ROC曲线分析NLR、PLR及癌胚抗原单独或联合检测在胃癌中诊断的作用,并得出其最佳cut-off值。结果胃癌组患者外周血NLR、PLR及血清癌胚抗原(CEA)中位值均高于胃良性病变组,两组间差异具有统计学意义(P <0. 05);利用Kruskal-Wallis检验分析显示,NLR、PLR的中位值随着胃恶性肿瘤浸润、淋巴结转移及临床分期程度增加数值变大,而与肿瘤不同部位、分化程度无显著相关性。另外,NLR、PLR、CEA的ROC曲线下面积(AUC)分别为0. 597、0. 677、0. 642,敏感度分别为29. 17%、50. 93%、37. 50%,特异度分别为91. 98%、75. 0%、88. 21%,其诊断最佳截点值分别为4. 98、180. 48、4. 77ng/ml;相对于胃良性疾病,联合检测指标中诊断胃癌敏感度最高的为NLR+PLR+CEA(75. 93%),NLR+CEA、PLR+CEA、NLR+PLR+CEA曲线下面积(AUC)分别为0. 695、0. 731、0. 732,特异度分别为83. 02%、62. 74%、58. 96%。结论外周血NLR、PLR有助于鉴别胃良性疾病与胃恶性肿瘤,NLR、PLR及血清CEA联合检测可提高对胃癌的诊断效能。
Objective To explore the clinical value and significance of neutrophil - lymphocyte ratio （NLR） , platelet - lymphocyte ratio （PLR） and carcinoembryonic antigen （CEA） in diagnosing the gastric cancer. Methods A retrospective analysis was made to the clinical data of 216 cases with gastric malignancy （cancer group） and 212 patients with benign gastric diseases （benign group） hospitalized during the period from Jan. , 2013 to Jan. , 2018 and the indexes of routine blood tests and CEA detections were analyzed as well; receiver operating characteristic （ROC） curve was applied in evaluating the value of single or combined detection of NLR, PLR and CEA in diagnosing gastric cancer so as to find out the best cut - off value. Results The mean values of NLR, PLR and CEA of the cases in cancer group were all higher than those of the cases in benign group statistical significance （ P 〈 0.05 ） ; Kruskal - Wallis test incated that the the levels of malignant gastric cancer infiltration, lymph node metastasis found with tumor location and differentiation grade; the area under ROC and the difference between the groups was of mean values of NLFI and PLR increased with and clinical staging while no correlation was curve （AUG） of NLR, PLR, and CEA was 0. 597, 0. 677, and 0. 642 respectively; the sensibility was 29.17% , 50.93% , and 37.50% , and the specificity was 91.98% , 75.0% , and 88.21% respectively; the best cut - off value was 4.98, 180.48, and 4.77 ng/ml respectively; the combined detection of NLR ＋ PLR ＋ CEA was of the highest sensibility in diagnosing gastric cancer （75. 93% ） ; the AUC of combined detection of NLR ＋ CEA, PLR ＋ CEA and NLR ＋ PLR ＋ CEA was 0. 695,0. 731 and 0.732 respectively while the specificity was 83.02% , 62.74% and 58.96% respectively. Conclusions NLR and PLR are of certain help in differnetiating begign gastric diseases from gastric malignancy and the combined detection of NLR, PLR and CEA can promote the diagnostic efficacy of gastric cancer.
作者
曾骞
周业江
Zeng Qian;Zhou Yejiang(Department of Gastrointestinal Surgery,Affiliated Hospital to Southwest Meical University,Luzhou City,Sichuan Province,646000,P.R.China)
出处
《西南军医》
2018年第6期627-631,共5页
Journal of Military Surgeon in Southwest China
关键词
胃癌
中性粒细胞/淋巴细胞比值
血小板/淋巴细胞比值
癌胚抗原
gastric cancer
neutrophil - lymphocyte ratio （NLR）
platelet - lymphocyte ratio （PLR）
carcinoembryonic antigen （CEA）
