外周血血小板/淋巴细胞比值联合糖链抗原125对上皮性卵巢癌的诊断价值
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摘要
目的探讨外周血血小板/淋巴细胞比值(platelet/lymphocyte ratio, PLR)联合糖链抗原125(carbohydrate antigen 125, CA125)对上皮性卵巢癌的诊断价值。方法上皮性卵巢癌患者80例为卵巢癌组,卵巢良性肿瘤患者100例为卵巢良性肿瘤组,比较2组PLR值和CA125水平,采用ROC曲线分析PLR、CA125及二者联合检测对上皮性卵巢癌的诊断价值。结果卵巢癌组外周血血小板计数[(272.60±61.12)×10~9/L]、PLR值(175.47±54.86)、血清CA125[(417.50(178.00,693.50)u/mL]水平高于卵巢良性肿瘤组[(199.32±49.44)×10~9/L、116.43±38.84、18.50(12.00,36.75)u/mL],淋巴细胞计数[(1.63±0.34)×10~9/L]低于卵巢良性肿瘤组[(1.78±0.30)×10~9/L](P<0.05);以PLR=155.15为最佳截断值,PLR诊断上皮性卵巢癌的AUC为0.804(95%CI:0.738～0.870,P<0.001),灵敏度为67.5%,特异度为87.0%,准确度为78.3%;以CA125=42.5 u/mL为最佳截断值,CA125诊断上皮性卵巢癌的AUC为0.911(95%CI:0.862～0.959,P<0.001),灵敏度为77.5%,特异度为82.0%,准确度为80.0%;CA125与PLR联合检测诊断上皮性卵巢癌的的AUC为0.942(95%CI:0.906～0.978,P<0.001),灵敏度为90.0%,特异度为79.0%,准确度为83.9%;CA125与PLR联合检测诊断上皮性卵巢癌的灵敏度和准确度明显高于CA125单独检测和PLR单独检测(P<0.05),特异度低于CA125单独检测和PLR单独检测(P<0.05)。结论 PLR是易获得的血清生物学标志物,PLR与CA125联合检测在上皮性卵巢癌的诊断方面具有良好的应用前景。
Objective To explore the value of joint detection of peripheral blood platelet/lymphocyte ratio(PLR) and carbohydrate antigen 125(CA125) to the diagnosis of epithelial ovarian cancer(EOC). Methods The levels of PLR and CA125 were detected and compared between 80 patients with EOC(EOC group) and 100 patients with benign ovarian tumors(benign group). The values of PLR and/or CA125 to the diagnosis of EOC were analyzed by ROC curve. Results The levels of peripheral blood platelet counts((272.60±61.12)×10~9/L), PLR(175.47±54.86) and CA125((417.50(178.00, 693.50) u/mL) in EOC group were significantly higher than those in benign group((199.32±49.44)×10~9/L, 116.43±38.84, 18.50(12.00, 36.75) u/mL), and lymphocyte count was significantly lower in EOC group((1.63±0.34)×10~9/L) than that in benign group((1.78±0.30)×10~9/L)(P<0.05). When the optimal cut-off value of PLR was 155.15, the AUC of PLR for the diagnosis of EOC was 0.804(95%CI: 0.738-0.870, P<0.001), the sensitivity was 67.5%, the specificity was 87.0% and the accuracy was 78.3%. When the optimal cut-off value of CA125 was 42.5 u/mL, the AUC for EOC was 0.911(95%CI: 0.862-0.959, P<0.001), the sensitivity was 77.5%, the specificity was 82.0% and the accuracy was 80.0%. The AUC for joint detection of PLR and CA125 was 0.942(95%CI: 0.906-0.978, P<0.001), the sensitivity was 90.0%, the specificity was 79.0%, and the accuracy was 83.9%. The sensitivity and accuracy of joint detection of PLR and CA125 for EOC were significantly higher than those of single CA125 or PLR(P<0.05), and the specificity was significantly lower than that of single CA125 or PLR alone(P<0.05). Conclusion As a readily available serum biomarker, PLR has a promising prospect in the diagnosis of EOC when combined with CA125.
Objective To explore the value of joint detection of peripheral blood platelet/lymphocyte ratio(PLR) and carbohydrate antigen 125(CA125) to the diagnosis of epithelial ovarian cancer(EOC). Methods The levels of PLR and CA125 were detected and compared between 80 patients with EOC(EOC group) and 100 patients with benign ovarian tumors(benign group). The values of PLR and/or CA125 to the diagnosis of EOC were analyzed by ROC curve. Results The levels of peripheral blood platelet counts((272.60±61.12)×10~9/L), PLR(175.47±54.86) and CA125((417.50(178.00, 693.50) u/mL) in EOC group were significantly higher than those in benign group((199.32±49.44)×10~9/L, 116.43±38.84, 18.50(12.00, 36.75) u/mL), and lymphocyte count was significantly lower in EOC group((1.63±0.34)×10~9/L) than that in benign group((1.78±0.30)×10~9/L)(P<0.05). When the optimal cut-off value of PLR was 155.15, the AUC of PLR for the diagnosis of EOC was 0.804(95%CI: 0.738-0.870, P<0.001), the sensitivity was 67.5%, the specificity was 87.0% and the accuracy was 78.3%. When the optimal cut-off value of CA125 was 42.5 u/mL, the AUC for EOC was 0.911(95%CI: 0.862-0.959, P<0.001), the sensitivity was 77.5%, the specificity was 82.0% and the accuracy was 80.0%. The AUC for joint detection of PLR and CA125 was 0.942(95%CI: 0.906-0.978, P<0.001), the sensitivity was 90.0%, the specificity was 79.0%, and the accuracy was 83.9%. The sensitivity and accuracy of joint detection of PLR and CA125 for EOC were significantly higher than those of single CA125 or PLR(P<0.05), and the specificity was significantly lower than that of single CA125 or PLR alone(P<0.05). Conclusion As a readily available serum biomarker, PLR has a promising prospect in the diagnosis of EOC when combined with CA125.
引文
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[2] SIEGEL R L, MILLER K D, JEMAL A. Cancer statistics 2017[J]. CA Cancer J Clin,2017,67(1):7-30.
[3] CHANG C, CHIANG A J, CHEN W A, et al. A joint model based on longitudinal CA125 in ovarian cancer to predict recurrence[J]. Biomark Med,2016,10(1):53-61.
[4] 和晓利,张菊新,靖爽,等.血清人附睾蛋白4和糖链抗原125诊断卵巢癌的价值[J].中华实用诊断与治疗杂志,2017,31(73):245-247.
[5] ASHER V, LEE J, INNAMAA A, et al. Preoperative platelet lymphocyte ratio as an independent prognostic marker in ovarian cancer[J]. Clin Transl Oncol,2011,13(7):499-503.
[6] KISIELEWSKI R, TOLWINSKA A, MAZUREK A, et al. Inflammation and ovarian cancer current views[J]. Ginekol Pol,2013,84(4):293-297.
[7] STONE R L, NICK A M, MCNEISH L A, et al. Paraneoplastic thrombocytosis in ovarian cancer[J]. N Engl Med,2012,366(7):610-618.
[8] MAEDA K, MALYKHIN A, TEAGUE-WEBER B N, et al. Interleukin-6 aborts lymphopoiesis and elevates production of myeloid cells in systemic lupus erythematosus-prone B6.Sle1.Yaa animals[J]. Blood,2009,113(19):4534-4540.
[9] WIECKOWSKI E U, VISUS C, SZAJNIK M, et al. Tumor-derived microvesicles promote regulatory T cell expansion and induce apoptosis in tumor-reactive activated CD8+ T lymphocytes[J]. J Immunol,2009,183(6):3720-3730.
[10] 汪辉,李晓,谢幸,等.卵巢癌细胞诱导T淋巴细胞凋亡的实验研究[J].中华妇产科杂志,2003,38(9):560-562.
[11] MANTOVANI A, ALLAVENA P, SICA A, et al. Cancer-related inflammation[J]. Nature,2008,454(7203):436-444.
[12] SALAZAR-ONFRAY F, LOPEZ M N, MENDOZA-NARANJOA M. Paradoxical effects of cytokines in tumor immune surveillance and tumor immune escape[J]. Cytokine Growth Factor Rev,2007,18(1/2):171-182.