外周血MPV、NLR、PLR及血浆CRP指标在子宫恶性肿瘤中的价值分析  

Analysis of values of MPV,NLR,PLR in peripheral blood and level of CRP in plasma in uterine malignant tumor

作　　者：王素华[1] 张强[1] 周黎黎[1] WANG Suhua;ZHANG Qiang;ZHOU Lili(Clinical Laboratory,The First Affiliated Hospital of Bengbu Medical College,Anhui 233000,China)

机构地区：[1]蚌埠医学院第一附属医院检验科,安徽蚌埠233000

出　　处：《淮海医药》2022年第3期253-257,共5页Journal of Huaihai Medicine

基　　金：蚌埠医学院自然科学重点项目(2021byzd149);安徽高校自然科学研究重点项目(KJ2019A0343);安徽省自然科学基金面上项目(1908085MH258)。

摘　　要：目的:观测外周血血小板平均体积(MPV)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)及血浆C反应蛋白(CRP)在子宫恶性肿瘤患者中的变化,分析其临床应用价值。方法:选取某院临床诊断明确的子宫病变患者235例作为观察组,其中子宫良性病变79例、宫颈癌前病变79例及恶性肿瘤患者77例,另外选取同期体检中心80名健康体检者作为对照组。对所有入选者行外周血MPV、PLT、淋巴细胞(LYM)、中性粒细胞(NEUT)及血浆CRP水平检测,根据所测数值计算NLR、PLR,采用单因素ANOVA检验和Spearman相关分析及绘制ROC曲线对各组间患者所测结果进行综合分析。结果:观察组外周血MPV为(11.08±1.30)fL,低于对照组的(12.34±1.22)fL,NLR、PLR和CRP水平分别为(2.20±0.67)、(123.01±34.81)、(2.58±2.71)mg/L,高于对照组的(1.91±0.54)、(102.25±23.92)、(0.51±0.20)mg/L,差异均有统计学意义(P<0.01)。良性病变组、癌前病变组、恶性肿瘤组3组间比较,外周血MPV呈降低趋势,NLR、PLR和CRP水平呈升高趋势,差异均有统计学意义(P<0.05)。Spearman相关分析显示,外周血MPV与子宫病变恶性程度呈负相关(P<0.01),NLR、PLR和CRP与子宫病变恶性程度呈正相关(P<0.01)。4项指标联合诊断子宫恶性肿瘤的ROC曲线下面积(AUC)是0.961,诊断效能明显高于单项指标。结论:外周血MPV与子宫病变恶性程度呈负相关,NLR、PLR和血浆CRP与子宫病变恶性程度呈正相关。肿瘤恶性程度越高,MPV越低,NLR、PLR和CRP越高,4项指标联合检测的诊断效能高于单一检测,可辅助临床对子宫恶性肿瘤患者进行诊断及鉴别诊断,可作为子宫恶性肿瘤诊断和病情评估的指标之一。Objective:To observe the changes of peripheral blood platelet mean volume(MPV),neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR)and plasma C-reactive protein(CRP)levels in patients with uterine malignant tumor,and to analyze the clinical application value.Methods:235 patients with clinical confirmed uterine lesions in a hospital were selected as the observation group,including 79 cases of benign uterine lesions,79 cases of precervical cancer lesions and 77 cases of malignant tumor.In addition,80 healthy subjects were selected as the control group from the physical examination center of the hospital.Routine peripheral blood MPV,PLT,lymphocyte(LYM),neutrophil(NEUT)and plasma CRP levels were detected in all the enrolled patients.NLR and PLR were calculated according to the measured values.One-way ANOVE test,Spearman correlation analysis and ROC curve were used to comprehensively analyze the results of patients in each group.Results:The MPV of peripheral blood in the observation group was(11.08±1.30)fL,lower than(12.34±1.22)fL in the control group.The levels of NLR,PLR and CRP in the observation group were(2.20±0.67),(123.01±34.81),(2.58±2.71)mg/L,higher than(1.91±0.54),(102.25±23.92),(0.51±0.20)mg/L in the control group(P<0.01).In the comparison among the benign lesion group,precancerous lesion group and malignant tumor group,MPV in peripheral blood decreased,NLR,PLR and CRP increased,and the differences were statistically significant(P<0.05).Spearman correlation analysis showed that MPV in peripheral blood was negatively correlated with the degree of uterine lesions(P<0.01),while NLR,PLR and CRP were positively correlated(P<0.01).The AUC of the area under the ROC curve for the combined diagnosis of uterine malignant tumors by 4 indexes was 0.961,the efficiency being significantly higher than that by one single index.Conclusion:MPV in peripheral blood is negatively correlated with the degree of uterine lesions,and NLR,PLR and plasma CRP are positively correlated.The higher the degree of maligna

关 键 词：子宫肿瘤 血小板平均体积 中性粒细胞/淋巴细胞比值 血小板/淋巴细胞比值 C反应蛋白 

分 类 号：R737.33[医药卫生—肿瘤]