摘要
目的探讨中性粒细胞与淋巴细胞比值(NLR)、癌胚抗原(CEA)联合凝血指标凝血酶原时间(PT)、活化部分凝血活酶时间(APTT)、凝血酶时间(TT)、纤维蛋白原(FIB)对直径≤1.0 cm的良恶性乳腺结节鉴别诊断的价值。方法选择2017年1月至2023年3月在新疆医科大学附属肿瘤医院行健康体检的直径≤1.0 cm乳腺结节患者为研究对象,将2017年1月至2020年6月的患者定义为训练集,2020年7月至2023年3月的患者定义为验证集。训练集中,良性乳腺结节患者83例,乳腺癌患者106例;验证集中,良性乳腺结节患者109例,乳腺癌患者136例。采用logistic回归分析乳腺结节良恶性的影响因素,二元logistic回归构建良恶性乳腺结节的诊断预测模型,受试者工作特征(ROC)曲线评价各项指标、诊断预测模型对乳腺结节良恶性的诊断效能。结果训练集与验证集中,良性乳腺结节患者与乳腺癌患者的中性粒细胞(t=6.76,P<0.001;t=9.14,P<0.001)、淋巴细胞(t=7.67,P<0.001;t=17.00,P<0.001)、NLR(t=13.97,P<0.001;t=17.41,P<0.001)、CEA(t=33.44,P<0.001;t=8.15,P<0.001)、PT(t=15.81,P<0.001;t=60.15,P<0.001)、APTT(t=39.50,P<0.001;t=16.34,P<0.001)、TT(t=13.34,P<0.001;t=14.37,P<0.001)、FIB(t=16.66,P<0.001;t=20.30,P<0.001)相比,差异均有统计学意义。单因素分析显示,中性粒细胞(OR=3.52,95%CI为1.26~5.37,P=0.036)、淋巴细胞(OR=2.64,95%CI为1.52~3.72,P=0.033)、NLR(OR=1.96,95%CI为1.15~3.42,P<0.001)、CEA(OR=2.16,95%CI为1.29~3.05,P<0.001)、PT(OR=1.75,95%CI为1.17~2.69,P<0.001)、APTT(OR=3.11,95%CI为1.55~5.38,P<0.001)、TT(OR=2.59,95%CI为1.38~4.11,P<0.001)、FIB(OR=2.89,95%CI为1.36~4.55,P<0.001)均是直径≤1.0 cm乳腺结节良恶性的影响因素。多因素分析显示,NLR(OR=2.06,95%CI为1.32~2.76,P<0.001)、CEA(OR=1.19,95%CI为1.09~1.37,P=0.008)、PT(OR=1.63,95%CI为1.05~2.11,P<0.001)、APTT(OR=1.52,95%CI为1.13~2.34,P<0.001)、TT(OR=1.64,95%CI为1.14~2.74,P<0.001)、FIB(OR=1.42,95%CI为1.11~1.89,P<0.001)均是直径≤1.0 cm乳
Objective To explore the value of neutrophil to lymphocyte ratio(NLR),carcinoembryonic antigen(CEA)combined with coagulation indicators prothrombin time(PT),activated partialthromboplastin time(APTT),thrombin time(TT),fibrinogen(FIB)in the differential diagnosis of benign and malignant breast nodules with a diameter of≤1.0 cm.Methods Patients with breast nodule diameter≤1.0 cm who underwent physical examination in the Cancer Hospital of Xinjiang Medical University from January 2017 to March 2023 were selected as the study objects.Patients admitted from January 2017 to June 2020 were defined as the training set,and patients admitted from July 2020 to March 2023 were defined as the validation set.In the training set,there were 83 patients with benign breast nodules and 106 patients with breast cancer;In the validation set,there were 109 patients with benign breast nodules and 136 patients with breast cancer.The influencing factors of benign and malignant breast nodules were analyzed by logistic regression.Binary logistic regression was used to construct the diagnosis and prediction model of benign and malignant breast nodules.Receiver operating characteristic(ROC)curve was used to evaluate the diagnostic performance of each index and diagnostic prediction model for benign and malignant breast nodules.Results There were statistically significant differences between patients with benign breast nodules and patients with breast cancer in the training and validation sets in neutrophils(t=6.76,P<0.001;t=9.14,P<0.001),lymphocytes(t=7.67,P<0.001;t=17.00,P<0.001),NLR(t=13.97,P<0.001;t=17.41,P<0.001),CEA(t=33.44,P<0.001;t=8.15,P<0.001),PT(t=15.81,P<0.001;t=60.15,P<0.001),APTT(t=39.50,P<0.001;t=16.34,P<0.001),TT(t=13.34,P<0.001;t=14.37,P<0.001),FIB(t=16.66,P<0.001;t=20.30,P<0.001).The results of univariate analysis showed that neutrophils(OR=3.52,95%CI:1.26-5.37,P=0.036),lymphocytes(OR=2.64,95%CI:1.52-3.72,P=0.033),NLR(OR=1.96,95%CI:1.15-3.42,P<0.001),CEA(OR=2.16,95%CI:1.29-3.05,P<0.001),PT(OR=1.75,95%CI:1.17-2.69,P<0.001
作者
王景
许文婷
Wang Jing;Xu Wenting(Department of Physical Examination and Health Management,Cancer Hospital of Xinjiang Medical University,Urumqi 830054,China;Department of Breast Tumor Surgery,Cancer Hospital of Xinjiang Medical University,Urumqi 830054,China)
出处
《国际肿瘤学杂志》
CAS
2023年第9期520-526,共7页
Journal of International Oncology
基金
新疆维吾尔自治区自然科学基金(2022D01C529)。
关键词
乳腺肿瘤
癌胚抗原
诊断
鉴别
中性粒细胞与淋巴细胞比值
凝血指标
Breast neoplasms
Carcinoembryonic antigen
Diagnosis,differential
Neutrophil to lymphocyte ratio
Coagulation indicators
