PLR和NLR对女性良恶性腹水鉴别诊断的预测价值  

Predictive value of PLR and NLR in differential diagnosis of benign and malignant ascites in women

作　　者：肖斯柔 肖盛[1] 肖丽君[1] 范自力(指导)[1] XIAO Si-Rou;XIAO Sheng;XIAO Li-Jun;FAN Zi-Li(Department of General Medicine,the Third Xiangya Hospital of Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院全科医学科,长沙410013

出　　处：《中国免疫学杂志》2020年第8期992-996,共5页Chinese Journal of Immunology

摘　　要：目的:评价外周血中性粒细胞/淋巴细胞比值(NLR)、间接中性粒细胞/淋巴细胞比值(dNLR)、血小板/淋巴细胞比值(PLR)、淋巴细胞/单核细胞比值(LMR)、平均血小板体积(MPV)等炎症指标对女性良恶性腹水鉴别诊断的预测价值。方法:回顾性分析274例女性腹水患者的临床病理资料,根据病因分为恶性腹水组130例、良性腹水组144例(包括类良性腹水组54例和单纯良性腹水组90例),比较各组患者外周血NLR、dNLR、PLR、LMR及MPV的差异,应用受试者工作特征曲线(ROC)评价单项指标在女性良恶性腹水鉴别诊断中的价值,多因素logistics回归分析筛选女性恶性腹水的独立预测因子。结果:女性恶性腹水患者外周血NLR、dNLR、PLR均明显高于良性腹水患者(P<0.05),LMR低于良性腹水患者(P<0.05),MPV差异无统计学意义(P>0.05)。良性腹水患者中单纯良性腹水组与类良性腹水组间各项指标差异无统计学意义(P>0.05)。外周血NLR、PLR曲线下面积分别为0.707、0.750;最佳截断值分别为2.29、217.84,灵敏度和特异度分别是86.2%和49.3%、65.4%和79.2%。dNLR、LMR曲线下面积低于0.700,不适用于女性腹水良恶性鉴别。多因素分析发现,经过年龄调整,NLR≥2.29、PLR≥217.84是女性恶性腹水的独立危险因素(P<0.05)。结论:外周血NLR、PLR对于女性腹水良恶性鉴别具有一定诊断价值,当NLR、PLR升高时应该警惕恶性腹水发生。Objective:To evaluate the predictive value of inflammatory markers such as the neutrophil-to-lymphocyte ratio(NLR),derived neutrophil-to-lymphocyte ratio(dNLR),lymphocyte-to-monocyte ratio(LMR),platelet-to-lymphocyte ratio(PLR)and mean platelet volume(MPV)in peripheral blood for the differential diagnosis of benign and malignant ascites in women.Methods:The clinicopathological data of 274 cases of female ascites were analyzed retrospectively.According to the cause,the patients were 130 cases of malignant ascites group and 144 cases of benign ascites group(including 54 cases of para-benign ascites group and 90 cases of simple benign ascites group).The differences of NLR,dNLR,PLR,LMR and MPV in peripheral blood of patients in each group were compared.The receiver operating characteristic curve(ROC curve)was used to evaluate the value of single index in differential diagnosis of benign and malignant ascites in wowen.Multivariate logistics regression analysis was used to screen the independent predictors of female malignant ascites.Results:NLR,dNLR and PLR in peripheral blood of patients with female malignant ascites were significantly higher than those with benign ascites(P<0.05),LMR was lower than patients with benign ascites(P<0.05),and there was no significant difference in MPV(P>0.05).In patients with benign ascites,there was no statistically significant difference between the para-benign ascites group and simple benign ascites group(P>0.05).The areas under the curve of NLR and PLR were 0.707 and 0.750,respectively.The best cutoff values were 2.29,217.84,the sensitivity and specificity were 86.2%and 49.3%,65.4%and 79.2%,respectively.The areas under the curve of dNLR and LMR were less than 0.700,which were not suitable for differentiating benign and malignant ascites in women.Multivariate analysis showed that after adjusting the age,NLR≥2.29 and PLR≥217.84 were independent risk factors for malignant ascites in women(P<0.05).Conclusion:Peripheral blood NLR and PLR have certain diagnostic value for the differen

关 键 词：腹水 鉴别诊断 中性粒细胞/淋巴细胞比值 血小板/淋巴细胞比值 

分 类 号：R477[医药卫生—护理学]