侵袭性分化型甲状腺癌外周血中性粒细胞/淋巴细胞比值的临床意义  

Clinical significance of blood neutrophil-to-lymphocyte ratio in patients with invasive well-differentiated thyroid cancer

作　　者：何时知 廉猛[1] 翟杰 钟琦[1] 陈晓红[1] 陈学军[1] 李平栋[1] 侯丽珍[1] 张洋[1] 马泓智[1] 冯凌[1] 时倩[1] 王茹[1] 房居高[1] HE Shizhi;LIAN Meng;ZHAI Jie;ZHONG Qi;CHEN Xiaohong;CHEN Xuejun;LI Pingdong;HOU Lizhen;ZHANG Yang;MA Hongzhi;FENG Ling;SHI Qian;WANG Ru;FANG Jugao(Department of Otolaryngology Head and Neck Surgery, Beijing Tongren Hospital, Capital Medical University,Beijing, 100730, China;Department of Otolaryngology Head and Neck Surgery, Sir Run Run Hospital, Nanjing Medical University, Nanjing, Jiangsu, 211166, China)

机构地区：[1]首都医科大学附属北京同仁医院耳鼻咽喉头颈外科,北京100730 [2]南京医科大学附属逸夫医院耳鼻咽喉头颈外科,江苏南京211166

出　　处：《中国耳鼻咽喉头颈外科》2019年第3期122-124,共3页Chinese Archives of Otolaryngology-Head and Neck Surgery

基　　金：首都医科大学基础-临床科研合作基金(17JL73)

摘　　要：目的检测侵袭性分化型甲状腺癌患者术前中性粒细胞与淋巴细胞比值(neutrophil-lymphocyte ratio,NLR),探讨用NLR指标评估局部晚期甲状腺癌的临床意义。方法采用1:1配对病例对照研究设计法,共收集侵袭性分化型甲状腺癌(侵袭组)和微小乳头状癌(非侵袭组)各40例患者,记录并计算术前NLR及C反应蛋白数值,比较侵袭组和非侵袭组之间的NLR和C反应蛋白的差异,以ROC曲线评价各指标对侵袭性分化型甲状腺癌的临床意义。结果侵袭组NLR为2.61±1.15,显著高于非侵袭组1.76±0.84,两组之间比较差异有统计学意义(F=5.016,P=0. 034),而两组之间C反应蛋白差异无统计学意义(F=2.136,P=0.158)。NLR对侵袭性分化型甲状腺癌患者诊断的曲线下面积为0.766,NLR诊断侵袭性分化型甲状腺癌的最佳临界值为1.95,敏感度为77.3%,特异度为69.1%。结论 NLR可以作为评价甲状腺癌患者局部侵袭的指标之一,NLR值越高,局部侵袭风险越大。OBJECTIVE To investigate the clinical significance of neutrophil-to-lymphocyte ratio (NLR) in patients with invasive well-differentiated thyroid cancer. METHODS Using 1:1 matched case-control study, 80 patients of invasive well-differentiated thyroid cancer (invasion group) and papillary thyroid micro-carcinoma (no-invasion group) were recruited and studied. The NLR and C-reactive protein were compared among different groups, and their diagnostic values were evaluated using the area under the receiver-operating characteristic (ROC) curve. RESULTS The NLR (F=5.016, P=0.034), but not C-reactive protein (F=2.136, P=0.158), had significant differece between the two groups. The NLR, 2.61 ± 1.15 in invasion group, was significantly higher than that in no-invasion group (P<0.05). The areas under the curve of NLR for the diagnosis of invasive well-differentiated thyroid cancer were 0.766;the optimal cut-off value of NLR was 1.95 for the diagnosis with a sensitivity of 77.3% and a specificity of 69.1%. CONCLUSION Preoperative NLR may be a prognostic marker in patients with thyroid cancer. High NLR is a risk factors influencing extra-thyroidal invasion of well-differentiated thyroid cancer.

关 键 词：甲状腺肿瘤 病例对照研究 C反应蛋白质 中性粒细胞-淋巴细胞比值 

分 类 号：R736.1[医药卫生—肿瘤]