PLR、NLR参数联合肿瘤标志物在非小细胞肺癌诊断中的价值
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摘要
目的探讨血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)、神经元特异性烯醇化酶(NSE)、细胞角蛋白19片段(Cyfra21-1)和癌胚抗原(CEA)联合检测在非小细胞肺癌(NSCLC)患者辅助诊断中的临床应用价值。方法选择2016年4月至2017年12月该院收治的NSCLC患者364例作为研究组,选择同期收治的肺部良性疾病患者209例作为对照组。采用血常规分析仪和电化学发光法检测两组患者PLR、NLR、NSE、Cyfra21-1和CEA 5项参数并进行比较。结果研究组患者5项参数检测结果均明显高于对照组,差异均有统计学意义(P<0.05);肺鳞癌患者PLR、Cyfra21-1检测结果均明显高于腺癌,CEA检测结果低于腺癌,差异均有统计学意义(P<0.05);Ⅲ/Ⅳ期患者NSE、Cyfra21-1、CEA检测结果均明显高于Ⅰ/Ⅱ期,T3、T4期患者5项指标检测结果均明显高于T1、T2期,差异均有统计学意义(P<0.05);5项参数均与NSCLC具有一定相关性,5项指标联合检测对NSCLC诊断的受试者工作特征曲线下面积最大(0.829),且联合检测灵敏度和准确性均最高,明显高于任何单项指标检测,差异均有统计学意义(P<0.05),但特异性有所降低,与其他单项检测比较,差异均有统计学意义表(P<0.05)。结论 PLR、NLR、NSE、Cyfra21-1和CEA 5项参数在NSCLC中高表达,且与临床病理和TNM分期具有一定相关性。联合检测可显著提高NSCLC辅助诊断的诊断效能、灵敏度和准确性,同时可为NSCLC的辅助诊断、治疗评估和预后监测提供一定的临床依据。
Objective To explore the clinical value of partial blood cell parameters(PLR),neutrophils and lymphocyte ratio(NLR),neuron-specific enolase(NSE),cytokeratin 19 fragments(Cyfra21-1)and carcinoembryonic antigen(CEA)to the auxiliary diagnosis of non small cell lung cancer(NSCLC).Methods The clinical data of 364 cases of NSCLC patients,who were received in the hospital from April 2016 to December2017,were collected as the study group,simultaneously 209 patients with benign lung diseases were collected as control group.Blood routine analyzer and electrochemilu minescene immunoassay were adopted to detect the parameters of PLR,NLR,NSE,Cyfra21-1 and CEA and the five parameters in the two groups were compared.Results The five parameters in the study group were higher than thosein the control group,with statistically significant difference(P<0.05).The results of PLR and Cyfra21-1 in patients with lung squamous cell carcinoma were significantly higher than those in patients with adenocarcinoma,but the result of CEA in patients was with lung squamous cell carcinoma lower than that in patients with adenocarcinoma,the difference showed statistical significance(P<0.05).The results of NSE,Cyfra21-1 and CEA in the clinical III/IV period were higher than those in the I/II stage,and the whole results of the T3,T4 stages were higher than those of T1,T2 stages,the difference had statistical significant(P<0.05).The five parameters were correlated with NSCLC,the area ROC curve of combination detection of 5 parameters was the largest(0.829)and the sensitivity and accuracy of the combination detection were significantly higher than any single index,with statistically significant difference(P<0.05),however,the specificity of combination was significantly lower than single detection,with statistically significant difference(P<0.05).Conclusion The five parameters of PLR,NLR,NSE,Cyfra21-1 and CEA are over-expression in patients with NSCLC,and there is correlation with clinical pathology and TNM stage.The combination detection can significantly improve the detection efficiency,sensitivity,accuracy and positive rate in the auxiliary diagnosis of NSCLC,and provide reliable clinical predictive value for NSCLC early diagnosis,treament and prognosis monitoring.
Objective To explore the clinical value of partial blood cell parameters(PLR),neutrophils and lymphocyte ratio(NLR),neuron-specific enolase(NSE),cytokeratin 19 fragments(Cyfra21-1)and carcinoembryonic antigen(CEA)to the auxiliary diagnosis of non small cell lung cancer(NSCLC).Methods The clinical data of 364 cases of NSCLC patients,who were received in the hospital from April 2016 to December2017,were collected as the study group,simultaneously 209 patients with benign lung diseases were collected as control group.Blood routine analyzer and electrochemilu minescene immunoassay were adopted to detect the parameters of PLR,NLR,NSE,Cyfra21-1 and CEA and the five parameters in the two groups were compared.Results The five parameters in the study group were higher than thosein the control group,with statistically significant difference(P<0.05).The results of PLR and Cyfra21-1 in patients with lung squamous cell carcinoma were significantly higher than those in patients with adenocarcinoma,but the result of CEA in patients was with lung squamous cell carcinoma lower than that in patients with adenocarcinoma,the difference showed statistical significance(P<0.05).The results of NSE,Cyfra21-1 and CEA in the clinical III/IV period were higher than those in the I/II stage,and the whole results of the T3,T4 stages were higher than those of T1,T2 stages,the difference had statistical significant(P<0.05).The five parameters were correlated with NSCLC,the area ROC curve of combination detection of 5 parameters was the largest(0.829)and the sensitivity and accuracy of the combination detection were significantly higher than any single index,with statistically significant difference(P<0.05),however,the specificity of combination was significantly lower than single detection,with statistically significant difference(P<0.05).Conclusion The five parameters of PLR,NLR,NSE,Cyfra21-1 and CEA are over-expression in patients with NSCLC,and there is correlation with clinical pathology and TNM stage.The combination detection can significantly improve the detection efficiency,sensitivity,accuracy and positive rate in the auxiliary diagnosis of NSCLC,and provide reliable clinical predictive value for NSCLC early diagnosis,treament and prognosis monitoring.
引文
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[7]李鹏,闫相涛,张国伟,等.血小板与淋巴细胞比值在非小细胞肺癌患者预后评估中的价值[J].中国实用医药,2016,11(13):5-7.
[8]黄焱,刘丹,李为民,等.小细胞肺癌患者中性粒细胞淋巴细胞比值与临床预后的相关因素分析[J].西部医学,2016,28(1):109-112.
[9] CHEN J,DENG Q,PAN Y,et al.Prognostic value of neutrophil-to-lymphocyte ratio in breast cancer[J].FEBS Open Bio,2015,5:502-507.
[10]尹竺晟,戈伟,罗卫.肿瘤标志物在非小细胞肺癌患者诊断中的价值[J].中国医药导报,2016,13(23):102-105.
[11]童天夫.血清CEA和CYFRA21-1检测对ⅢB、Ⅳ期非小细胞肺癌患者化疗疗效的评估[J].国际检验医学杂志,2018,39(3):361-363.
[12]陈一超,辇伟奇,冉静,等.肿瘤标志物联合检测对肺癌诊断、病理分型和临床分期的临床价值[J].国际检验医学杂志,2018,29(1):32-37.
[13]王琳,张冠男,周莉,等.中性粒细胞淋巴细胞比值对小细胞肺癌患者预后的评估价值[J].承德医学院学报,2017,34(1):28-30.
[14]何兴,黄钦蓉,刘瑛,等.肺癌化疗患者CEA、NSE、SCCAg与血小板相关性分析[J].临床肺科杂志,2018,23(7):1228-1231.
[15]赵松林,聂秀红.血清CEA、CYFRA21-1和SCC对晚期非小细胞肺癌化疗效果的评估价值[J].标记免疫分析与临床,2018,25(5):620-623.
[2]卢兴兵,石佳,李勤,等.血清肿瘤志物在诊断转移性肺癌中的临床价值[J].检验医学与临床,2018,15(2):179-182.
[3] XU L,LI L,LI J,et al.Overexpression of miR-1260bin Non-small Cell Lung Cancer is Associated with Lymph Node Metastasis[J].Aging Dis,2015,6(6):478-485.
[4]高利常,赵振兴,裴银辉,等.非小细胞肺癌患者血清miR-133b表达变化及其意义[J].山东医药,2017,57(23):61-63.
[5] KANO S,HOMMA A,HATAKEYAMA H,et al.Pretreatment lymphocyte-to-monocyte ratio as an independent prognostic factor for head and neck cancer[J].Head Neck,2017,39(2):247-253.
[6]潘颖,管世鹤,杨凯,等.外周血血小板/淋巴细胞比值在非小细胞肺癌诊断中的价值[J].细胞与分子免疫学杂志,2016,32(12):1683-1686.
[7]李鹏,闫相涛,张国伟,等.血小板与淋巴细胞比值在非小细胞肺癌患者预后评估中的价值[J].中国实用医药,2016,11(13):5-7.
[8]黄焱,刘丹,李为民,等.小细胞肺癌患者中性粒细胞淋巴细胞比值与临床预后的相关因素分析[J].西部医学,2016,28(1):109-112.
[9] CHEN J,DENG Q,PAN Y,et al.Prognostic value of neutrophil-to-lymphocyte ratio in breast cancer[J].FEBS Open Bio,2015,5:502-507.
[10]尹竺晟,戈伟,罗卫.肿瘤标志物在非小细胞肺癌患者诊断中的价值[J].中国医药导报,2016,13(23):102-105.
[11]童天夫.血清CEA和CYFRA21-1检测对ⅢB、Ⅳ期非小细胞肺癌患者化疗疗效的评估[J].国际检验医学杂志,2018,39(3):361-363.
[12]陈一超,辇伟奇,冉静,等.肿瘤标志物联合检测对肺癌诊断、病理分型和临床分期的临床价值[J].国际检验医学杂志,2018,29(1):32-37.
[13]王琳,张冠男,周莉,等.中性粒细胞淋巴细胞比值对小细胞肺癌患者预后的评估价值[J].承德医学院学报,2017,34(1):28-30.
[14]何兴,黄钦蓉,刘瑛,等.肺癌化疗患者CEA、NSE、SCCAg与血小板相关性分析[J].临床肺科杂志,2018,23(7):1228-1231.
[15]赵松林,聂秀红.血清CEA、CYFRA21-1和SCC对晚期非小细胞肺癌化疗效果的评估价值[J].标记免疫分析与临床,2018,25(5):620-623.