术前外周血中性粒细胞/淋巴细胞比值在乳腺癌诊断中的作用  

Preoperative peripheral blood neutrophil-to-lymphocyte ratio in the diagnosis of breast cancer

作　　者：赵卫卫[1] 肖林林[1] 刘秀芬[1] 彭攸[1] 黄丁丁[1] 王玉平[1] 冯景[1] ZHAO Weiwei;XIAO Linlin;LIU Xiufen;PENG You;HUANG dingding;WANG Yuping;FENG Jing(Department of Clinical Laboratory,South Campus,Shanghai Jiaotong University Affiliated Sixth People's Hospital,Shanghai 201499,China)

机构地区：[1]上海交通大学附属第六人民医院南院检验科,上海201499

出　　处：《检验医学》2018年第3期209-212,共4页Laboratory Medicine

基　　金：上海市奉贤区科委课题(奉科20131303)

摘　　要：目的探讨术前外周血中性粒细胞/淋巴细胞比值(NLR)在乳腺癌诊断中的最佳临界值及其在临床诊断中的作用。方法选取131例行手术治疗的乳腺癌患者(乳腺癌组)和120例乳腺良性病变患者(乳腺良性疾病组),并以95名女性体检健康者作为正常对照组。采用SYSMEX XT-800i全自动血液分析仪计数中性粒细胞(NE)和淋巴细胞(LY),计算NLR;采用电化学发光法检测外周血糖类抗原15-3(CA15-3)、糖类抗原125(CA125)、癌胚抗原(CEA)水平。根据受试者工作特征(ROC)曲线确定最佳临界值。结果乳腺癌组术前NLR、NE、LY、CA15-3明显高于正常对照组和乳腺良性疾病组(P<0.05)。NLR的曲线下面积(AUC)为0.935,最佳临界值为1.995,敏感性为85.2%,特异性为87.1%。以NLR为检测基础,联合CA15-3诊断乳腺癌的敏感性为98.0%,特异性为92.6%。结论 NLR诊断乳腺癌的最佳临界值为1.995,联合CA15-3能增加乳腺癌诊断的敏感性和特异性,对乳腺癌的诊断、病情评估具有指导意义。Objective To investigate the role and optimal cut-off value of preoperative peripheral blood neutrophil-to-lymphocyte ratio(NLR)in the diagnosis of breast cancer.Methods A total of 131 breast cancer patients undergoing surgery and 120 patients with benign breast disease were enrolled.Totally,95 healthy females were enrolled as healthy control group.Neutrophil(NE)and lymphocyte(LY)counts were determined by SYSMEX XT-800i automatic hematology analyzer,and NLR was calculated.The levels of carbohydrate antigen 15-3(CA15-3),carbohydrate antigen 125(CA125)and carcinoembryonic antigen(CEA)in peripheral blood were determined by electrochemiluminescence.According to receiver operating characteristic(ROC)curve,the optimal cut-off value was determined.Results In breast cancer group,NLR,NE,LY and CA15-3 were higher than those in healthy control and benign breast disease groups(P<0.05).The area under curve(AUC)of NLR was 0.935,the optimal cut-off value was 1.995,the sensitivity was 85.2%,and the specificity was 87.1%.Based on NLR determination,the sensitivity and specificity of the combined determination with CA15-3 were 98.0%and 92.6%,respectively could improve the sensitivity.Conclusions The optimal cut-off value of NLR is 1.995,and the sensitivity and specificity can be improved through the combined determination with CA15-3 in the diagnosis of breast cancer,which can guide the diagnosis and disease severity assessment of breast cancer.

关 键 词：中性粒细胞/淋巴细胞比值 糖类抗原15-3 乳腺癌 

分 类 号：R446.1[医药卫生—诊断学]