摘要
目的探讨术前外周血炎性相关指标中性粒细胞-淋巴细胞计数比值(NLR)、血小板-淋巴细胞计数比值(PLR)联合糖蛋白抗原19-9(CA19-9)对结肠癌早期诊断及预后评估的应用价值。方法选取2015年5月至2017年3月宜宾市第二人民医院收治的189例结肠癌患者为结肠癌组,另选取同期健康体检志愿者72例为对照组。受试者均进行外周血常规检查并计算NLR及PLR比值,采用电化学发光法检测血清CA19-9水平,受试者工作特征曲线(ROC)分析NLR、PLR、CA19-9对结肠癌的诊断效能。根据NLR、PLR、CA19-9以及联合检测结果分为阳性组与阴性组,采用Kaplan-Meier法分析不同检测指标对结肠癌患者预后评估的应用价值。结果与对照组相比,结肠癌组患者NLR、PLR比值及CA19-9水平均显著升高(P<0.05);ROC分析显示NLR曲线下面积(AUC)为0.787,敏感度为62.96%,特异度为79.17%,准确性为67.43%;PLR检测的AUC为0.776,敏感度为65.61%,特异度为76.39%,准确性为68.58%;CA19-9 AUC为0.735,敏感度为61.90%,特异度为84.72%,准确性为68.20%;三项联合检测敏感度为91.01%,特异度为97.22%,准确性为92.72%;Kaplan-Meier分析显示NLR、PLR、CA19-9及联合检测阳性组患者OS均分别显著低于各阴性组(P<0.05),仅联合检测风险比(HR)最高,HR=2.188(χ^2=15.167,P<0.001,95%CI=1.310~3.656)。结论 NLR、PLR联合CA19-9检测可提高临床早期诊断结肠癌的敏感度及准确性,且三项联合检测对结肠癌患者预后评估具有重要指导意义。
Objective To investigate the value of neutrophil/lymphocyte count ratio(NLR),platelet/lymphocyte count ratio(PLR) combined with carbohydrate antigen 19-9(CA19-9) in the early diagnosis and prognosis evaluation of colon cancer. Methods From May 2015 to March 2017, one hundred and eighty-nine patients with colon cancer admitted to the Second People’s Hospital of Yibin City were selected as colon cancer group, and 72 healthy volunteers were selected as control group. All the subjects underwent routine blood tests and NLR and PLR were calculated, serum CA19-9 level was detected by electrochemiluminescence, and the receiver operating characteristic curve(ROC) was used to analyze the diagnostic efficiency of NLR, PLR and CA19-9 for colon cancer. According to the results of NLR, PLR,CA19-9 and combined detection, the patients were divided into positive group and negative group. KaplanMeier method was used to analyze the application value of different detection indicators in prognosis evaluation of patients with colon cancer. Results Compared with the control group, the NLR, PLR and CA19-9 levels in colon cancer group were significantly higher(P<0.05). ROC analysis showed that the area under curue(AUC) of NLR was 0.787, the sensitivity 62.96%, the specificity 79.17%, and the accuracy67.43%. The AUC of PLR was 0.776, the sensitivity 65.61%, the specificity 76.39%, and the accuracy68.58%. The AUC of CA19-9 was 0.735, the sensitivity 61.90%, the specificity 84.72%, and the accuracy68.20%. The sensitivity of the three combined test was 91.01%, the specificity was 97.22%, the accuracy was 92.72%;the combined test was significantly higher than single tests(P<0.05). Kaplan-Meier analysis showed that the overall survival(OS) of NLR, PLR, CA19-9 and the combined tests positive group were significantly lower than those of the negative group(P<0.05), while the combined HR value was the highest,which was 2.188(χ^2=15.167, P<0.001, 95%CI=1.310-3.656). Conclusion NLR and PLR combined with CA19-9 test can improve the sensitivity and
作者
叶序卷
姚兰
刘世呈
戴红梅
Ye Xujuan;Yao Lan;Liu Shicheng;Dai Hongmei(Department of Oncology, the Second People’s Hospital of Yibin City, Yibin 644000, China;Department of Clinical Laboratory, the Third People’s Hospital of Chengdu, Chengdu 610014, China)
出处
《中华普通外科学文献（电子版）》
2019年第4期274-278,共5页
Chinese Archives of General Surgery(Electronic Edition)
基金
2018年四川省卫生和计划生育委员会科研课题(18PJ126,18PJ112)
2016年四川省卫生和计划生育委员会科研课题(16PJ049)
