炎症指标与结直肠腺瘤上皮内瘤变分级的相关性分析  

Correlations between inflammatory indexes and gradings of intraepithelial colorectal adenomas

作　　者：刘书娟 崔静[1] LIU Shujuan;CUI Jing(Department of Gastroenterology,the Second Affiliated Hospital,Zhengzhou University,Zhengzhou 450014,Henan,China)

机构地区：[1]郑州大学第二附属医院消化内科,河南郑州450014

出　　处：《癌变．畸变．突变》2023年第1期49-53,共5页Carcinogenesis,Teratogenesis & Mutagenesis

摘　　要：目的:研究结直肠腺瘤患者外周血中炎症因子的变化,探讨炎症指标与结直肠腺瘤上皮内瘤变分级的相关性。方法:回顾性分析200例经病理诊断的结直肠腺瘤患者临床资料,按瘤变分级分为低级别上皮内瘤变组(LGIN)和高级别上皮内瘤变组(HGIN),对两组患者的年龄、性别、腺瘤位置、腺瘤数量、最大腺瘤直径、外周血中性粒细胞计数、血小板计数、单核细胞计数、淋巴细胞计数、平均血小板体积(MPV)、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)、系统性免疫炎症指数(SII)、癌胚抗原(CEA)等的临床病特征进行ROC曲线分析获得最佳截断值。并对危险因素进行单因数分析和二元Logistic回归分析。结果:ROC曲线分析结果显示,PLR、NLR、SII、MLR的曲线下面积分别为0.614、0.653、0.656、0.593,最佳截断值分别为165.01、1.87、465.71、0.26。单因素分析显示,PLR、NLR、SII、MLR、CEA、淋巴细胞绝对值、中性粒细胞绝对值、腺瘤位置、最大腺瘤直径与结直肠腺瘤的上皮内瘤变分级相关。Logistic回归分析结果显示,PLR[OR=0.978,95%CI(0.957,1.000)]、SII[(OR=1.006,95%CI(1.000,1.103)]和最大腺瘤直径[(OR=5.058,95%CI(2.929,8.733)]是结直肠腺瘤发生高级别上皮内瘤变独立的危险因素。结论:结直肠腺瘤患者外周血中炎症指标血小板与淋巴细胞比值、系统性免疫炎症指数越高,提示高级别上皮内瘤变可能性越大,二者与结直肠腺瘤上皮内瘤变分级呈正相关。OBJECTIVE:To detect changes of inflammatory factors in intraepithelial colorectal adenomas,and to investigate correlations between the factors and gradings of the adenomas. METHODS:Clinical data from 200 cases of patients with adenomas were retrospectively analyzed. The adenomas were divided into different groups according to their neoplasia grades. Age, sex, adenoma location, number of adenomas,maximum adenoma diameter, counts of neutrophils, platelets, monocytes and lymphocytes, mean platelet volumes, ratios of platelets to lymphocytes(PLR), neutrophils to lymphocytes(NLR) and monocytes to lymphocytes(MLR), systemic Immune-inflammation indices(SII), and carcinoembryonic antigens(CEA) were analyzed. RESULTS:The AUC of PLR,NLR,SII,MLR were 0.614,0.653,0.656 and 0.593,respectively.The optimal cut-off values of PLR, NLR, SII, MLR were 165.01, 1.87, 465.71 and 0.26, respectively.Univariate analyses showed that PLR,NLR,SII,MLR,CEA,neutrophil count、lymphocyte count,adenoma location, maximum adenoma diameter were significantly related to the neoplasia grades of the adenomas.According to the binary Logistic regression analyses,PLR,SII and maximum adenoma diameters were the risk factors for high-grade intraepithelial neoplasia. CONCLUSION: The higher the platelet-to-lymphocyte ratios and systemic inflammatory response indices in the peripheral blood of patients with colorectal adenomas,the greater the likelihood of high-grade intraepithelial neoplasia. Their positive correlations may be useful for enhancing therapy for colorectal adenoma.

关 键 词：结直肠腺瘤 炎症标志物 血小板与淋巴细胞比值 系统性免疫炎症指数 上皮内瘤变 

分 类 号：R735.34[医药卫生—肿瘤]