血小板计数联合其他血液常规检查预测胸片可疑肺癌的可能性分析  

A combination of platelet count and other routine blood tests to predict radiologically suspected lung cancer

作　　者：荆朝辉[1] 李明秋[1] 韦柳炎[1] 梁振艳[1] 

机构地区：[1]南京医科大学附属无锡市人民医院心血管外科,214000

出　　处：《内蒙古中医药》2011年第24期1-2,共2页Inner Mongolia Journal of Traditional Chinese Medicine

摘　　要：目的:评价胸片可疑肺癌病例中联合检测血小板计数及其他血液常规实验室检查来预测肺癌的可行性。方法:本研究前瞻性收集了连续189个胸片可疑肺癌患者,检测其血小板计数、血红蛋白、白细胞计数、红细胞沉降率(ESR)、血清乳酸脱氢酶。根据术后病理分为良性病例组(n=98)与恶性病例组(n=91)。肺癌病人根据TNM系统进行分期,所有肿块根据组织类型进行分型。结果:8%(8/98)的良性病例出现血小板增多症(血小板计数>400*109,)而在恶性病例中血小板增多症的发生率为57%(52/91)(p<0.0001)。其中,原发性肺癌中,血小板增多症的发病率为53%(40/76)。在肿瘤晚期病例(TNM IIII、V期)中,血小板增多症的发病率尤高。血小板增多症联合乳酸脱氢酶升高及ESR增高,则预测的敏感性可达到0.71,而特异性可达到1.00。阳性预测值为1.00,而阴性预测值为0.89。结论:肺癌病人中血小板增高症发病率较高。如果联合血小板计数与其他常规血液检测如白细胞计数、ESR及血清乳酸脱氢酶等检查,可以作为预测肺癌发生率的一个较好的指标。Objective To evaluate the clinical value of an elevated platelet count and other routine laboratory tests for predicting malignancy in patients with radiologically suspected lung cancer.Platelet count,hemoglobin,total leukocyte count,erythrocyte sedimentation rate（ESR） and serum lactate dehydrogenase（LDH） were analysed in 189 prospectively admitted patients with suspected lung cancer.Methods The patients were divided by pathologic diagnosis into those with benign disorders（n=98） and with malignancies（n=91）.Patients with lung cancer were staged（TNM） and the tumors were classified according to histological types（WHO）.Results Thrombocytosis（platelet400＊109/L） was present in 8（8/98） of patients with benign disease and 57%（52/91） of patients with malignant disease（p0.00001）.The prevalence of thrombocytosis in patients with primary lung cancer was 53%（40/76）.Elevated platelet count was more common in advanced disease（stage III and IV）.No difference was observed between histological types.The sensitivity of thrombocytosis for predicting malignancy was 0.57 and the specificity was 0.92.When elevated platelet counts,LDH and ESR were combined,a sensitivity of 0.71 and a specificity of 1.00 was achieved.The positive and negative predictive values were 1.00 and 0.89,respectively.Conclusion Elevated platelet count is frequently observed in patients with lung cancer.When test results of platelet count and other routine blood analyses are combined,a high sensitivity and specificity for predicting malignancy was achieved.These tests are clinically useful in evaluation of patients with radiologically suspected lung cancer.

关 键 词：血小板增多症 肺癌 红细胞沉降率 

分 类 号：R734.2[医药卫生—肿瘤]