术前炎性指标联合肿瘤标志物在肺腺癌复发转移中的预测价值  

The predictive value of preoperative inflammatory markers combined with tumor markers in the recurrence and metastasis of lung adenocarcinoma

作　　者：曾强 张宇[2] 李海波 ZENG Qiang;ZHANG Yu;LI Hai-bo(Department of Thoracic Surgery,Chengdu Hospital of Integrated Traditional Chinese and Western Medicine,Chengdu 610094,China;Department of Orthopedics,Chengdu Hospital of Integrated Traditional Chinese and Western Medicine,Chengdu 610094,China)

机构地区：[1]成都市中西医结合医院胸外科,四川成都610094 [2]成都市中西医结合医院骨科,四川成都610094

出　　处：《实用医院临床杂志》2022年第6期24-28,共5页Practical Journal of Clinical Medicine

基　　金：四川省科技计划资助项目(编号:2021JDKP0078)。

摘　　要：目的 探讨术前炎性指标联合肿瘤标志物对肺腺癌复发转移的预测价值,及其指导术后患者进行补充治疗的可行性。方法 收集2014年11月至2019年1月我院胸外科接受肺癌根治术的82例肺腺癌患者(试验组)的术前血液学指标。同期67例肺部良性肿瘤患者为对照组,记录血小板/淋巴细胞比值(PLR)、中性粒细胞/淋巴细胞(NLR)、系统炎症指数(SII)、癌胚抗原(CEA)、糖抗原(CA)19-9、CA125等指标。对亚组间的炎性指标及肿瘤标志物进行比较。结果 试验组NLR、PLR、SII、CEA高于对照组(P<0.05);疾病稳定(SD)组中性粒细胞、NLR、单核细胞、PLR、SII、纤维蛋白原、CEA、CA125、CA19-9低于疾病进展(PD)组(P<0.05),联合检测SII、NLR、CA125三项指标对肺腺癌复发转移的ROC曲线下面积最大(0.856),阳性病例组无进展生存时间和无进展生存率均低于阴性病例组(P<0.05)。结论 术前SII、NLR、CA125三项指标联合检测有助于预测肺腺癌术后患者的复发/转移,对其阳性患者需积极采取补充治疗。Objective To explore the predictive value of preoperative inflammatory markers combined with tumor markers in the recurrence and metastasis of lung adenocarcinoma, and the feasibility of guiding postoperative patients for supplementary therapy.Methods Eighty-two patients with lung adenocarcinoma who underwent radical lung cancer surgery at the department of thoracic surgery of our hospital from November 2014 to January 2019 were selected as an experimental group. Another 67 patients with benign lung tumors during the same period were selected as a control group. Platelet/lymphocyte ratio(PLR), neutrophil/lymphocyte ratio(NLR), systemic inflammation index(SII), carcinoembryonic antigen(CEA), carbohydrate antigen(CA) 19-9, and CA125 were recorded. Inflammatory indicators and tumor markers were compared between subgroups.Results The NLR, PLR, SII and CEA of the experimental group were higher than those of the control group(P<0.05). The neutrophils, NLR, monocytes, PLR, SII, fibrinogen, CEA, CA125, and CA19-9 of patients in the stable disease(SD) group were lower than those of patients in the progressive disease(PD) group(P<0.05). The combined detection of SII, NLR, and CA125 had the largest area under the ROC curve for the recurrence and metastasis of lung adenocarcinoma(0.856). The progression-free survival time and progression-free survival rate of the patients in the positive case group were significantly lower than those in the negative case group(P<0.05).Conclusions The combined detection of SII, NLR and CA125 before surgery can help predict the recurrence/metastasis of patients with lung adenocarcinoma after surgery. Supplementary treatment should be actively taken for positive patients.

关 键 词：肺腺癌 炎性指标 肿瘤标记 复发转移 预后 

分 类 号：R734.2[医药卫生—肿瘤]