血小板相关参数与甲状腺肿瘤的关系研究  

Study on the correlation between platelet related parameters and thyroid cancer

作　　者：朱莹 吴惠玲[1] 高晓玲[1] 乔焱源 ZHU Ying;WU Hui-ling;GAO Xiao-ling(Department of Clinical Laboratory,Yuxi People's Hospital,Yuxi 653100,China)

机构地区：[1]玉溪市人民医院,653100

出　　处：《中国实用医药》2022年第10期23-26,共4页China Practical Medicine

基　　金：云南省教育厅科学研究基金项目(项目编号:2018JS260)项目名称:Atg14在甲状腺癌发生发展及I131治疗中的作用。

摘　　要：目的 研究外周血血小板相关参数与甲状腺肿瘤的关系,分析其对甲状腺肿瘤诊断与预后的价值。方法 636例接受甲状腺切除术的甲状腺肿瘤患者,根据手术病理结果不同分为甲状腺乳头状癌(PTC)组(353例)和结节性甲状腺肿(MNG)组(283例);并选取同期252例健康体检人群作为对照组。比较PTC组和MNG组患者术前与对照组血小板参数[血小板计数(PLT)、平均血小板体积(MPV)、血小板分布宽度(PDW)、血小板压积(PCT)、大血小板比率(P-LCR)、血小板和淋巴细胞比值(PLR)];分析血小板参数与PTC的关系,血小板参数对甲状腺恶性肿瘤的诊断效能。结果 PTC组和MNG组患者术前PLR、MPV、PCT及P-LCR均高于对照组,PTC组患者术前PLR、MPV、PCT及P-LCR高于MNG组,三组比较差异有统计学意义(P<0.05);Logistic回归分析显示:MPV、PCT、PLR及P-LCR是PTC的危险因素(P<0.05)。MPV、PCT、PLR及P-LCR对判断是否为恶性肿瘤具有较好的准确性,PLR的受试者工作特征(ROC)曲线下面积(AUC)为0.857,MPV为0.845,PCT为0.761,P-LCR为0.809,均>0.7;联合预测因子对判断是否为恶性肿瘤具有较高的准确性,AUC为0.961,敏感度为0.871,特异度为0.952,约登指数为0.823。结论 血小板相关参数可作为甲状腺肿瘤的一种辅助诊断,并能预测及评估病情。Objective To study the correlation between platelet related parameters and thyroid cancer,and analyze their value in the diagnosis and prognosis of thyroid tumors.Methods A total of 636 patients with thyroid tumors who underwent thyroidectomy were divided into papillary carcinoma of the thyroid(PCT) group(353 patients) and micronodular goiter(MNG) group(283 patients) according to the surgical pathological findings;and 252 healthy subjects during the same period were selected as the control group.The platelet parameters[platelet count(PLT),mean platelet volume(MPV),platelet distribution width(PDW),platelet crit(PCT),latelet-large cell ratio(P-LCR),platelet lymphocyte ratio(PLR)] were compared between the PTC group and the MNG group before surgery and the control group.The correlation between platelet parameters and PTC,and the diagnostic efficiency of platelet parameters for thyroid malignancies were analyzed.Results The preoperative PLR,MPV,PCT and P-LCR of the patients in the PTC group and the MNG group were higher than those in the control group,and the preoperative PLR,MPV,PCT and P-LCR in the PTC group were higher than those in the MNG group,and the differences among the three groups were statistically significant(P<0.05).Logistic regression analysis showed that MPV,PCT,PLR and P-LCR were risk factors for PTC(P<0.05).MPV,PCT,PLR and P-LCR had good accuracy in judging whether it was a malignant tumor.The area under curve(AUC) of the receiver operating characteristic(ROC) of PLR was 0.857,MPV was 0.845,PCT was 0.761,P-LCR was 0.809,all >0.7.The combined predictors had high accuracy in judging whether it was a malignant tumor,the AUC was 0.961,the sensitivity was 0.871,the specificity was 0.952,and the Youden index was 0.823.Conclusion Platelet-related parameters can be used as a auxiliary diagnosis of thyroid cancer,and can predict and evaluate the condition of disease.

关 键 词：甲状腺肿瘤 血小板计数 平均血小板体积 血小板分布宽度 血小板压积 大血小板比率 临床诊断 

分 类 号：R736.1[医药卫生—肿瘤]