摘要
目的研究乳酸脱氢酶(LDH)、淋巴细胞/单核细胞比值(LMR)及肺癌炎症指数(ALI在肺癌诊断及预后评估中的预测价值。方法选取2019年3月-2021年3月南京医科大学附属苏州医院收治的非小细胞肺癌患者161例,根据病理组织学结合影像分析行肿瘤分期诊断,其中Ⅰ~Ⅱ期52例,Ⅲ~Ⅳ期109例。比较不同分期患者血清LDH、LMR及ALI水平,分析血清LDH、LMR、ALI单一及三者联合检测对肺癌的诊断价值;分析无进展生存期(PFS)与总生存期(OS)与临床病理特征及血清LDH、LMR及ALI水平的关系,分析影响肺癌患者生存预后的影响因素。结果Ⅲ~Ⅳ期血清LDH、LMR水平高于Ⅰ~Ⅱ期,血清ALI水平低于Ⅰ~Ⅱ期,差异具有统计学意义(P<0.05)。LDH+LMR+ALI检测敏感性及特异性高于单一检测,敏感性及特异性分别为92.07%、86.38%。随访结束,161例肺癌患者中位PFS为8月,中位OS为12月。不同年龄、性别、病理类型的肺癌患者PFS、OS比较差异无统计学意义(P>0.05);吸烟与不吸烟、临床分期Ⅰ~Ⅱ期与临床分期Ⅲ~Ⅳ期、血清LDH<230 U/L与LDH≥230 U/L、LMR<5.93与LMR≥5.93、ALI>45.83与ALI≤45.83的PFS、OS比较差异有统计学意义(P<0.05)。COX单因素分析显示,吸烟、临床分期为Ⅲ~Ⅳ期、血清LDH≥230 U/L、LMR≥5.93及ALI≤45.83是影响肺癌患者OS的不良预后因素(P<0.05);COX多因素分析显示,临床分期为Ⅲ~Ⅳ期、血清LDH≥230 U/L、LMR≥5.93及ALI≤45.83是影响肺癌患者OS的独立预后危险因素(P<0.05)。结论检测血清LDH、LMR及ALI对肺癌诊断具有一定价值,三者联合可提高诊断敏感性、特异性;同时,LDH、LMR及ALI可作为影响肺癌总生存预后的独立危险因素,早期检测LDH、LMR及ALI利于评估肺癌患者预后。
Objective To study the predictive value of lactate dehydrogenase(LDH),lymphocyte/monocyte ratio(LMR)and advanced lung cancer inflammatory index(ALI)in the diagnosis and prognosis evaluation of lung cancer.Methods 161 patients with non-small cell lung cancer admitted to Suzhou Hospital of Nanjing Medical University from March 2019 to March 2021 were selected.According to histopathology combined with image analysis,the tumor stages were diagnosed,including 52 cases of stageⅠ~Ⅱand 109 cases of stageⅢ~Ⅳ.Serum LDH,LMR and ALI levels of patients were compared at different stages,and the diagnostic value of serum LDH,LMR and ALI alone or combined detection was analyzed;the relationship between progression-free survival(PFS)and overall survival(OS)and clinicopathological features,serum LDH,LMR and ALI levels were analyzed,the influencing factors on survival and prognosis of patients with lung cancer were analyzed.Results The serum LDH and LMR levels in stageⅲ-ⅳwere higher than those in stageⅰ-ⅱ,and the serum ALI levels in stageⅲ-ⅳwere lower than those in stageⅰ-ⅱ,the difference was statistically significant(P<0.05).The sensitivity and specificity of LDH+LMR+ALI detection were higher than those of single detection,the sensitivity and specificity were 92.07%and 86.38%,respectively.At the end of follow-up,the median PFS of 161 patients with lung cancer was 8 months and the median OS was 12 months.There is no statistically significant difference in PFS and OS between lung cancer patients of different ages,genders,and pathological types(P>0.05);there were statistically significant differences in PFS and OS between smoking and non-smoking,clinical stageⅠ~Ⅱand clinical stageⅢ~Ⅳ,and serum LDH<230 U and LDH≥230 U/L,LMR<5.93 and LMR≥5.93,ALI>45.83 and ALI≤45.83(P<0.05);COX multivariate analysis showed that clinical stageⅲⅳ,serum LDH≥230 U/L,LMR≥5.93 and ALI≤45.83 were independent prognostic risk factors for OS in lung cancer patients(P<0.05).Conclusion Detecting serum LDH,LMR and ALI
作者
顾海迪
王晨洁
杨军
GU Haidi;WANG Chenjie;YANG Jun(Department of Oncology,Suzhou Hospital,Nanjing Medical University,Nanjing,Jiangsu,China,215000)
出处
《分子诊断与治疗杂志》
2023年第12期2189-2193,共5页
Journal of Molecular Diagnostics and Therapy
基金
苏州市科技计划项目(SYS2020167)
苏州市科技发展计划项目(SKJYD2021118)。
