外周血NLR、MLR、PLR和SII在宫颈癌中的临床意义分析  

Clinical significance of peripheral blood NLR,MLR,PLR and SII levels in patients with cervical cancer

作　　者：朱光琼 许华斌[1] 陈传平[2] 张光满[1] ZHU Guangqiong;XU Huabin;CHEN Chuanping;ZHANG Guangman(Department of Clinical Laboratory,Affiliated Hospital of West Anhui Health Vocational College,Lu′an,Anhui 237008,China;Department of Medical Technology,West Anhui Health Vocational College,Lu′an,Anhui 237005,China)

机构地区：[1]皖西卫生职业学院附属医院检验科,安徽六安237008 [2]皖西卫生职业学院医学技术系,安徽六安237005

出　　处：《国际检验医学杂志》2021年第10期1208-1212,1218,共6页International Journal of Laboratory Medicine

基　　金：安徽省教育厅高校优秀拔尖人才培育资助项目(2019gxbjZD76)。

摘　　要：目的探讨中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)、血小板与淋巴细胞比值(PLR)及系统性免疫性炎症指数(SII)在宫颈癌中的变化及临床意义。方法以67例宫颈癌患者(宫颈癌组)、169例宫颈癌前病变患者(宫颈癌前病变组)、42例体检健康女性(对照组)作为研究对象,根据检测的血常规结果分别计算NLR、MLR、PLR和SII,比较NLR、MLR、PLR和SII在宫颈癌组、宫颈癌前病变组和对照组中的变化,并分析其鉴别诊断宫颈癌和宫颈癌前病变的价值,以及与年龄、临床病理特征的关系。结果NLR、MLR、PLR和SII在对照组、宫颈癌前病变组和宫颈癌组中依次升高,两两比较,差异有统计学意义(P<0.05)。NLR、MLR、PLR和SII随着上皮内瘤变级别的升高逐渐升高,差异有统计学意义(P<0.05)。NLR、MLR、PLR和SII鉴别诊断宫颈癌和宫颈癌前病变的受试者工作特征(ROC)曲线下面积分别为0.724、0.700、0.646和0.733,最佳诊断截断值分别为2.11、0.20、120.81、662.29。SII的诊断效能最好,其灵敏度、特异度、阳性预测值、阴性预测值、符合率和Youden指数分别为55.22%、81.07%、53.62%、82.04%、73.73%和0.36。以最佳诊断截断值对宫颈癌患者进行分层后发现,NLR≥2.11或MLR≥0.20或SII≥662.29的宫颈癌患者中肿瘤浸润深度≥深肌层、FIGO分期为Ⅲ~Ⅳ期和有淋巴结转移的例数明显多于NLR<2.11或MLR<0.20或SII<662.29患者数,PLR≥120.81患者中肿瘤分期为Ⅲ~Ⅳ期和有淋巴结转移的例数明显多于PLR<120.81患者,差异有统计学意义(P<0.05)。结论外周血NLR、MLR、PLR和SII可鉴别诊断宫颈癌和宫颈癌前病变,SII诊断的特异度最高。NLR、MLR和SII对肿瘤的浸润程度、FIGO分期和淋巴结转移具有一定的预测价值,PLR对FIGO分期和淋巴结转移具有一定的预测价值。Objective To investigate the changes and significance of neutrophil to lymphocyte ratio(NLR),monocyte to lymphocyte ratio(MLR),platelet to lymphocyte ratio(PLR)and systemic immune inflammatory index(SII)in cervical cancer.Methods A total of 67 cases of cervical cancer(cervical cancer group),169 cases of cervical precancerous lesions(cervical precancerous lesion group)and 42 cases of healthy women(control group)were selected as the research objects.According to the blood routine results,NLR,MLR,PLR and SII were calculated,the changes of NLR,MLR,PLR and SII in cervical cancer group,cervical precancerous lesion group and control group were analyzed,the differential diagnostic efficacy of NLR,MLR,PLR and SII in cervical cancer and cervical precancerous lesions,and their correlations with age and clinicopathological features were analyzed.Results NLR,MLR,PLR and SII increased successively in control group,cervical precancerous lesion group and cervical cancer group(P<0.05).NLR,MLR,PLR and SII increased with the grade of intraepithelial neoplasia(P<0.05).Receiver operating characteristic(ROC)curve analysis showed that AUC of NLR,MLR,PLR and SII in the diagnosis of cervical cancer were 0.724,0.700,0.646 and 0.733,the cut-off were 2.11,0.20,120.81 and 662.29 respectively.The diagnostic efficiency of SII was the best,the sensitivity,specificity,positive predictive value,negative predictive value,coincidence rate and Youden index were 55.22%,81.07%,53.62%,82.04%,73.73%and 0.36 respectively.Cervical cancer patients were layered according to the best diagnostic cut-off point,then found that the number of tumor invasion depth≥deep muscle layer,FIGO staging wasⅢ-Ⅳperiod and lymph node metastases in NLR≥2.11 or MLR≥0.20 or SII≥662.29 patients were significant more than the number in NLR<2.11 or MLR<0.20 or SII<662.29 patients,the number of FIGO staging wasⅢ-Ⅳperiod and lymph node metastases in PLR≥120.81 patients were significant more than the number in PLR<120.81 patients(P<0.05).Conclusion Peripheral blood N

关 键 词：宫颈癌 宫颈癌前病变 中性粒细胞与淋巴细胞比值 单核细胞与淋巴细胞比值 血小板与淋巴细胞比值 系统性免疫性炎症指数 

分 类 号：R446.6[医药卫生—诊断学]