乳腺癌患者血小板/淋巴细胞比值及红细胞分布宽度检测的临床价值  

Clinical significance of preoperative platelet to lymphocyte ratio and red cell distribution width in patients with breast cancer

作　　者：钟田花[1] 王文强[1] 陈振辉 穆小萍[1] ZHONG Tian-hua;WANG Wen-qiang;CHEN Zhen-hui;MU Xiao-ping(Department of Clinical Laboratory,Guangdong Women and Children Hospital,Guangzhou 511400,CHINA)

机构地区：[1]广东省妇幼保健院检验科,广东广州511400

出　　处：《海南医学》2018年第16期2284-2287,共4页Hainan Medical Journal

摘　　要：目的探讨乳腺癌患者术前外周血血小板/淋巴细胞比值(PLR)及红细胞分布宽度(RDW)检测的临床价值。方法将2015年1月至2016年9月间在广东省妇幼保健院确诊的115例乳腺癌初诊患者作为乳腺癌组,以同期健康女性120例为健康对照组,比较两组受检者的PLR、RDW的水平,同时分析乳腺癌患者PLR、RDW与雌激素受体(ER)、孕激素受体(PR)、人表皮生长因子受体-2(HER-2)及TNM分期的关系。采用受试者工作特征曲线(ROC)分析PLR、RDW对乳腺癌的诊断价值。结果乳腺癌组患者的PLR高于健康对照组,但组间比较差异无统计学意义(P>0.05),而乳腺癌组患者的RDW高于对照组,组间比较差异有统计学意义(P<0.05);根据PLR水平将乳腺癌组患者分为高PLR(>127.50)组和低PLR(≤127.50)组,高PLR组和低PLR组患者在ER、PR、HER-2、TNM分期方面比较差异均无统计学意义(P>0.05);根据RDW水平将乳腺癌组患者分为高RDW(>13.3%)组和低RDW(≤13.30%)组,高RDW组和低RDW组在TNM分期中比较差异有统计学意义(P<0.05),而在ER、PR、HER-2表达中比较差异均无统计学意义(P>0.05);PLR诊断乳腺癌的最佳阈值为115.49,其ROC曲线下面积为0.559(P>0.05),敏感度和特异度分别为65.9%及47.7%;RDW诊断乳腺癌的最佳阈值为13.35%,其ROC曲线下面积为0.619(P<0.01),敏感度和特异度分别为47.7%及75.7%。结论术前RDW水平对乳腺癌的诊断具有较高的特异性,而且可能是判断乳腺癌病情的一个重要指标。Objective To evaluate the clinical significance of pre-operative platelet to lymphocyte ratio（PLR）and red cell distribution width（RDW） in peripheral blood of patients with breast cancer. Methods A total of 115 patients with breast cancer who admitted to Guangdong Women and Children Hospital from January 2015 to September2016 were selected as the breast cancer group. Meanwhile, 120 healthy women were chosen as the control group. The difference of PLR and RDW levels of the two groups were compared. The relationship of PLR, RDW in patients with breast cancer and clinical pathological parameters（estrogen receptor [ER], progesterone receptor [PR], human epidermal growth factor receptor 2 [HER2], and Tumor, Node, Metastasis [TNM] staging） were analyzed. Receiver operating characteristic（ROC） curve was used to analyze the diagnostic value of PLR and RDW for breast cancer. Results RDW in breast cancer group was significantly higher than that in control group（P0.05）, but PLR had no statistically difference between the two groups（P0.05）. There was no significant difference between the high PLR（127.50） group and the low PLR（≤127.50） group among ER, PR, HER-2, TNM staging（P0.05）. There was a significant difference between the high RDW（13.3%） group and the low RDW（≤13.30%） group in TNM staging in breast cancer patients（P0.05）,with no significant difference in the expression of ER, PR, HER-2（P0.05）. The optimum cutoff value of PLR for diagnosing breast cancer was 115.49 and the area under the ROC curve was 0.559（P0.05）, and the sensitivity and specificity were 65.9% and 47.7% respectively. The optimum cutoff value of RDW for diagnosing breast cancer was 13.35% and the area under the ROC curve was 0.619（P0.01）, and the sensitivity and specificity were 47.7% and 75.7%, respectively. Conclusion The level of pre-operative RDW has high specificity in the diagnosis of breast cancer and might be an important indicator for the severity evaluation of breast cancer.

关 键 词：乳腺癌 血小板/淋巴细胞比值 红细胞分布宽度 

分 类 号：R737.9[医药卫生—肿瘤]