中性粒细胞与淋巴细胞计数比在乳腺导管内乳头状肿瘤鉴别诊断中的价值  

Diagnostic value of neutrophil lymphocyte ratio for intraductal papillary neoplasms of breast

作　　者：吴伟[1] 田文[1] 苗欣[1] 沈少平 赵永亮[1] 张艳君[1] WU Wei TIAN Wen MIAO Xin SHEN Shaoping ZHAO Yongliang ZHANG Yanjun(Department of General Surgery, Chinese PLA General Hospital, Beijing 100853, China)

机构地区：[1]解放军总医院普通外科,北京100853

出　　处：《解放军医学院学报》2017年第7期628-630,661,共4页Academic Journal of Chinese PLA Medical School

摘　　要：目的探讨中性粒细胞淋巴细胞比率(neutrophil lymphocyte ratio,NLR)在乳腺导管内乳头状肿瘤良恶性鉴别诊断中的价值。方法回顾性分析2014年7月-2016年6月在本院乳腺中心经手术治疗的乳腺导管内乳头状肿瘤患者的临床资料。依据病理结果分为乳腺导管内乳头状瘤组和乳腺导管内乳头状癌组,对两组对应的NLR、年龄、绝经状态、乳头溢液及肿瘤大小等因素进行比较分析。采用ROC曲线分析NLR鉴别良恶性肿瘤的价值并得出最佳cut-off值。结果本研究共纳入乳腺导管内乳头状肿瘤患者175例,其中乳腺导管内乳头状瘤122例(69.71%),乳腺导管内乳头状癌53例(30.29%)。良性组和恶性组对应的NLR值分别为(1.76±0.78)和(2.60±1.14)(P<0.05)。ROC曲线得出乳腺导管内乳头状肿瘤良恶性鉴别诊断的NLR最佳cut-off值为1.90,此时对应敏感度为77.40%,特异度为67.20%,阳性预测值为84.45%,诊断精确度为74.31%,AUC为0.766。结论 NLR值可辅助术前乳腺导管内乳头状肿瘤良恶性的鉴别诊断,高NLR值提示恶性可能。Objective To investigate the diagnostic value of neutrophil lymphocyte ratio in intraductal papillary neoplasms （IDPN） of breast. Methods Clinical data about patients diagnosed as intraductal papillary neoplasms of breast from July 2014 to June 2016 were analyzed retrospectively in Breast Disease Center, Chinese PLA General Hospital. The patients were divided into benign group and malignant group according to postoperative pathologic results, and neutrophil lymphocyte ratio （NLR）, age, menopause, nipple discharge and tumor size in each group were compared. Furthermore, the optimal cut-off value of NLR in the differentiation of benign and malignant neoplasms was obtained by ROC curve. Results A total of 175 patients were diagnosed as intraductal papillary neoplasms of breast. There were 122 （69.71%） cases diagnosed as intraductal papilloma and 53 （30.29%） cases diagnosed as intraductal papillary carcinoma. NLR values were （1.76±0.78） in benign group and （2.60±1.14） in malignant group, respectively （P ＜ 0.05）. NLR was the main factor associated with the classification of IDPN （P ＜ 0.05）. The optimal NLR cut-off value obtained from ROC analysis was 1.90 with AUC of 0.766, sensitivity of 77.40%, specificity of 67.20%, positive predictive value of 84.45% and diagnostic accuracy of 74.31%, respectively. Conclusion Preoperative NLR is helpful to differentiate malignant intraductal papillary neoplasm of breast from benign tumor, and high NLR is a significant diagnostic predictor of breast cancer.

关 键 词：导管内乳头状肿瘤 乳腺肿瘤 中性粒细胞淋巴细胞比率 鉴别诊断 

分 类 号：R446.6[医药卫生—诊断学]