摘要
目的探讨红细胞分布宽度(RDW)、平均血小板体积(MPV)和癌胚抗原(CEA)对肾细胞癌患者(RCC)和肾良性肿瘤的鉴别诊断价值。方法收集2015年10月至2018年10月在徐州医科大学附属医院就诊的135例肾细胞癌(RCC组)和155例肾良性肿瘤患者(肾良性肿瘤组),另选取同时期同医院健康体检者140例设为对照组。比较各组RDW、MPV、CEA等临床生化指标,分析RCC患者术前RDW和MPV与临床病理特征的相关性,并采用ROC曲线分析联合检测对RCC、肾良性肿瘤患者和健康人群鉴别诊断的准确性。结果血红蛋白(Hb)、血小板计数(PLT)、RDW、MPV和CEA水平在三组之间差异均有统计学意义(P<0.01)。RCC组RDW水平[(17.6±2.0)%]分别高于肾良性肿瘤组[(14.9±1.8)%]和对照组[(13.8±1.1)%,P<0.05];RCC组MPV水平[(8.4±0.9)fl]分别低于肾良性肿瘤组[(10.4±1.1)fl]和对照组[(10.8±1.2)fl,P<0.05]。RDW、MPV和CEA联合检测对RCC和肾良性肿瘤鉴别准确性的ROC曲线下面积(AUC)为0.958(0.929~0.990),RDW、MPV和CEA联合检测对RCC和健康人群鉴别的准确性AUC为0.930(0.897~0.964),均明显高于三个指标单项检测及任意两项联合检测的AUC(P<0.05,P<0.01)。结论RDW、MPV和CEA联合检测可以在临床上有效区分RCC和肾良性肿瘤,其鉴别效能优于各项单独检测或任意两项联合检测。
Objective To explore the value of red blood cell distribution width(RDW),mean platelet volume(MPV) and carcinoembryonic antigen(CEA) in the differential diagnosis of renal cell carcinoma and benign renal tumor.Methods A total of 135 patients with renal cell carcinoma(RCC group)and 155 patients with benign renal tumors(BRT group) were enrolled from October 2015 to October 2018,and 140 healthy subjects were served as control group in the same period.Before operation,RDW,MPV,CEA and other biochemical parameters were compared in two groups to analyze the associations of RDW and MPV with clinicopathological characteristics in patients with renal cell carcinoma,and a receiver operating characteristic(ROC) curve analysis was used to evaluate the accuracy in differential diagnosis of renal cell carcinoma,benign renal tumor and healthy populations.Results There were significant differences in the levels of hemoglobin(HB),platelet count(PLT),RDW,MPV and CEA among the three groups(P<0.01).RDW level in RCC group [(17.6±2.0)%] was higher than those in BRT group[(14.9±1.8)%] and control group [(13.8±1.1)%],and MPV level in RCC group [(8.4±0.9)fl] was lower than those in BRT group [(10.4±1.1)fl] and control group [(10.8 ±1.2)fl,P<0.05].The area under ROC curve(AUC) of combined detection of RDW,MPV and CEA was 0.958(0.929-0.990) in differential diagnosis of RCC and BRT,and was 0.930(0.897-0.964) in differential diagnosis of RCC and healthy population,which were significantly higher than the AUC of single index or any two joint detection(P<0.05,P<0.01).Conclusion The combined detection of RDW,MPV and CEA can effectively distinguish renal cell carcinoma and benign renal tumor in clinical practice,and its differentiation efficiency is better than any individual or combination detection.
作者
周臣
杨焕
王军起
ZHOU Chen;YANG Huan;WANG Jun-qi(Department of Urology,Affiliated Hospital of Xuzhou Medical University,Xuzhou,Jiangsu 221000,China)
出处
《中国临床研究》
CAS
2020年第5期606-610,共5页
Chinese Journal of Clinical Research
关键词
红细胞分布宽度
平均血小板体积
癌胚抗原
肾细胞癌
肾良性肿瘤
Red blood cell distribution width
Mean platelet volume
Carcinoembryonic antigen
Renal cell carcinoma
Benign renal tumor
