多项血液学指标联合检测对鼻腔鼻窦恶性肿瘤的诊断价值  

Detection of multiple biological markers in diagnosis of malignant tumors of nasal cavity and paranasal sinuses

作　　者：吴淋蓉 崔翔[1] 任远[1] 叶栋[1] 沈志森[1] WU Linrong;CUI Xiang;REN Yuan;YE Dong;SHEN Zhisen(Department of Otorhinolaryngology,Head and Neck Surgery,Li Huili Hospital,Ningbo Medical Center,Ningbo 315040,China)

机构地区：[1]宁波市医疗中心李惠利医院耳鼻咽喉头颈外科,315040

出　　处：《浙江医学》2022年第24期2648-2650,2655,共4页Zhejiang Medical Journal

基　　金：浙江省自然科学基金资助项目(LQ21H130001);浙江省基础公益研究计划项目(LY19H160014);宁波市医疗卫生品牌学科建设项目(PPXK2018-02)。

摘　　要：目的 分析血液学指标白蛋白(ALB)、乳酸脱氢酶(LDH)、中性粒细胞/淋巴细胞比值(NRL)、β2微球蛋白(β2-MG)、碱性磷酸酶(ALP)对鼻腔鼻窦恶性肿瘤(SNM)的诊断价值。方法 选取2016年1月至2021年6月宁波市医疗中心李惠利医院收治的行鼻腔鼻窦肿瘤活检或切除术治疗的SNM患者64例为观察组,另择同期来本院健康体检者128名为对照组。观察组患者术前抽取静脉血检测ALB、LDH、NRL、β2-MG、ALP水平,对照组收集健康体检时静脉血标本检测以上血液学指标。观察并比较两组ALB、LDH、NRL、β2-MG、ALP水平,并分析以上指标对SNM的诊断效能。结果 两组ALB、NRL、β2-MG、ALP水平比较差异均有统计学意义(均P<0.05),观察组ALB水平低于对照组,NRL、β2-MG、ALP水平高于对照组,而两组LDH水平比较差异无统计学意义(P>0.05)。ROC曲线分析显示,ALB、NRL、β2-MG、ALP表达水平用于诊断SNM的AUC分别为0.71、0.72、0.69、0.68,灵敏度分别为0.875、0.828、0.859、0.398,特异度分别为0.672、0.578、0.438、0.891,最佳截断值分别为42.85 g/L、2.35、1.95 mg/L、64.50 U/L。以上指标联合诊断的ROC曲线,AUC为0.818,灵敏度为0.892,特异度为0.641。结论血液学指标ALB、NRL、β2-MG、ALP联合检测对SNM有较高的诊断价值。Objective To investigate detection of multiple biological markers in diagnosis of malignant tumors in nasal cavity and paranasal sinus(SNM). Methods Sixty-four patients with SNM who were admitted to Li Huili Hospital of Ningbo Medical Center and underwent tumor resection of nasal cavity and paranasal sinuses from January 2016 to June 2021 were enrolled in the study, and 128 healthy subjects undergoing physical examination were selected as the control group. The albumin(ALB), lactate dehydrogenase(LDH), neutrophil/lymphocyte ratio(NRL), β2-microglobulin(β2-MG) and alkaline phosphatase(ALP) levels were detected in all subjects, and the diagnostic efficacy of the above indicators for SNM was analyzed. Results There were significant differences in the levels of ALB, NRL, β2-MG and ALP between SNM patients and healthy controls(all P<0.05). The level of ALB in the SNM group was lower than that in the control group and levels of NRL, β2-MG and ALP were higher than those in the control group, while there was no significant difference in the levels of LDH between the two groups(P>0.05). ROC curve showed that the AUC of ALB, NRL, β2-MG and ALP for diagnosing SNM were 0.71, 0.72,0.69 and 0.68;the sensitivity was 0.875, 0.828, 0.859 and 0.398;the specificity was 0.672, 0.578, 0.438 and 0.891;and the optimal cut-off values were 42.85 g/L, 2.35, 1.95 mg/L and 64.50 U/L, respectively. The AUC of the combination of above indicators was 0.818, sensitivity was 0.892, and specificity was 0.641. Conclusion Combined detection of ALB, NRL, β2-MG and ALP has a relatively high diagnostic efficiency for SNM.

关 键 词：鼻腔鼻窦恶性肿瘤 诊断 白蛋白 乳酸脱氢酶 中性粒细胞/淋巴细胞比值 Β2微球蛋白 碱性磷酸酶 

分 类 号：R739.62[医药卫生—肿瘤]