喉部良恶性病变患者外周血淋巴细胞与单核细胞比值及意义  

The significance of lymphocyte to monocyte ratio in peripheral blood of patients with benign and malignant laryngeal lesions

作　　者：伍大权 黄新生[1] 

机构地区：[1]复旦大学附属中山医院耳鼻咽喉头颈外科,上海200032

出　　处：《临床耳鼻咽喉头颈外科杂志》2017年第11期835-838,共4页Journal of Clinical Otorhinolaryngology Head And Neck Surgery

基　　金：上海市科委基金(No:14DZ1940703);中山医院青年基金(No:2016ZSQN41)

摘　　要：目的:探讨术前外周血淋巴细胞单核细胞比值(LMR)在区分喉鳞状细胞癌(LSCC)、喉癌前病变(LPL)以及喉良性病变(LBL)中的作用。方法:收集405例经病理确诊的喉部病变患者(LSCC组154例,LPL组83例,LBL组168例),LSCC组按T分期进一步分为T1组、T2组和T3~4组,检测各组术前外周血中性粒细胞、淋巴细胞、单核细胞、血红蛋白和血小板等计数,并比较各组中LMR、中性粒细胞淋巴细胞比值(NLR)及其他指标。结果:LBL、LPL、LSCC各组中LMR和NLR值分别为4.88±1.65和4.61±1.59、3.92±1.77和2.11±0.79、2.08±0.77和2.63±1.69,LSCC组LMR较LBL组和LPL组小,且差异有统计学意义(P<0.01),而NLR较LBL组和LPL组大(P<0.05),LBL组和LPL组之间LMR和NLR差异均无统计学意义(P>0.05)。LSCC组中局部晚期(T3~4期)患者较局部早、中期(T1、T2期)患者LMR小,而NLR值大且差别具有统计学意义(P<0.05)。LBL、LPL、LSCC三组的血小板、白细胞、中性粒细胞数之间差异无统计学意义(P>0.05)。结论:本研究首次比较不同喉部病变中的LMR,并发现LMR、NLR作为全身性的炎症指标对区分LSCC和LPL及LBL具有一定的参考价值。Objective ： The aim of this study is to investigate the value of preoperative peripheral blood lympho- cyte to monocyte ratio（LMR） in differentiating laryngeal squamous cell carcinoma（LSCC）, laryngeal precancerous lesions（LPL） and laryngeal benign lesions（LBL）. Method： Four hundred and five cases of laryngeal lesions diag- nosed by pathology（154 cases of LSCC, 83 cases of LPL and 168 cases of LBL） were collected. LSCC group was further divided into T1 group, T2 group and T3-4 group based on T stage. The levels of neutrophils, lympho- cytes, monocytes, hemoglobin, platelet and other blood indexes were measured, as well as compared the LMR, neutrophil to lymphocyte ratio（NLR） and other parameters in each group. Result.. The LMR and NLR in LBL, LPL and LSCC groups was 4.88±1.65 and 4.61±1. 59, 3. 9211.77 and 2. 11 ±0.79,2.08±0. 77 and 2.63± 1.69, respectively. The LMR in the LSCC group was significantly lower than those in the LBL and LPL group （P〈.01）, whereas the NLR was significantly higher than those in LBL and LPL group（P〈.05）. Either LMR or NLR between the LBL and LPL group was not statistically different（P〈.05）. The LMR of patients with local advanced（T3-4） stage in the LSCC group was lower than that in the early or medium stage（T1-2）, while the NLR was higher and the difference was statistically significant（P〈.05）. There was no significant difference in platelet, white blood cell and neutrophil count between LBL, LPL and LSCC（P〈.05）. Conclusion.- We , for the first time, compared LMR in different laryngeal lesions and found that LMR and NLR as a systemic inflammatory index have a certain reference value for to differentiate LSCC from LPL and LBL.

关 键 词：喉肿瘤 喉癌前病变 喉良性病变 淋巴细胞单核细胞比值 

分 类 号：R739.65[医药卫生—肿瘤]