NLR和PLR在甲状腺癌诊断及术后TSH抑制治疗中的意义  

Significance of NLR and PLR in Diagnosis of Thyroid Carcinoma and Postoperative TSH Suppression Therapy

作　　者：代豹 牛建华[2] 习羽[2] 钟晨[2] 贾贵红 杨婕 DAI Bao;NIU Jian-hua;XI Yu;ZHONG Chen;JIA Gui-hong;YANG Jie(Shihezi University School of Medicine,Xinjiang Shihezi,832002;Department of Gastrointestinal and Thyroid Surgery,the First Affiliated Hospital of Shihezi University School of Medicine,Xinjiang Shihezi,832008)

机构地区：[1]石河子大学医学院,新疆石河子832002 [2]石河子大学医学院第一附属医院胃肠甲状腺外科,新疆石河子832008

出　　处：《农垦医学》2022年第6期490-495,共6页Journal of Nongken Medicine

摘　　要：目的:探讨中性粒细胞-淋巴细胞比率(NLR)、血小板-淋巴细胞比率(PLR)及两指标联合(NLR-PLR)在甲状腺癌诊断及术后TSH抑制治疗中的意义。方法:收集我院297例患者作为研究对象进行回顾性分析,将促甲状腺激素(Thyroid Stimulating Hormone,TSH)<0.5m U/L定义为治疗有效组,TSH≥0.5m U/L定义为治疗无效组,分析NLR、PLR等临床特征与甲状腺癌及术后TSH抑制疗效的关系,并构建受试者工作特征曲线(ROC),分析NLR、PLR等临床特征与甲状腺癌及术后药物疗效的关系,根据术前NLR、PLR值将其分为高值和低值并进行赋分,NLR-PLR评分0~2分。结果:甲状腺结节中恶性组NLR、PLR值显著高于良性组,差异具有统计学意义(P<0.05);ROC分析中,NLR-PLR联合诊断曲线下面积(AUC=0.959)显著高于NLR、PLR单独诊断甲状腺良、恶性结节患者的AUC(0.759、0.725),且敏感度及特异度均显著增高;多因素分析显示TSH与术后治疗效果无显著相关性,体质指数(BMI)、NLR、PLR是甲状腺癌术后TSH抑制治疗效果的独立危险因素(P<0.05);在ROC分析中,区分甲状腺癌术后TSH抑制治疗NLR的AUC=0.649,截断值为1.66,敏感度0.796,特异度0.548;PLR的AUC=0.698,截断值为159.656,敏感度0.926,特异度0.466;BMI曲线下面积0.70,截断值为24.78,敏感性度0.759,特异度0.630。NLR-PLR评分在TSH抑制治疗无效组中显著高于有效组,差异具有统计学意义(P<0.05)。结论:NLR、PLR及NLR-PLR是预测甲状腺癌及甲状腺癌术后TSH抑制治疗疗效的简单有效又有前景的一种方法,可为甲状腺癌术后个体化抑制治疗提供新的研究思路。Objective:To investigate the significance of neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR)and combination of the two indexes(NLR-PLR)in the diagnosis and postoperative endocrine suppression of thyroid carcinoma.Methods:297 patients in our hospital were collected and analyzed retrospectively.TSH<0.5m U/L was defined as effective group,TSH≥0.5m U/L was defined as ineffective group.The relationship between clinical features such as NLR,PLR and thyroid cancer and postoperative endocrine inhibition was analyzed,and the receiver operating characteristic curve(ROC)was constructed.The relationship between clinical features such as NLR,PLR and thyroid cancer,postoperative drug efficacy was analyzed.According to the preoperative NLR and PLR values,the patients were divided into high value and low value,and the NLR-PLR score was 0-2.Results:The values of NLR and PLR in malignant thyroid nodules were significantly higher than those in benign thyroid nodules,and the areas under the curves(AUC=0.959)of NLR-PLR in ROC analysis was significantly higher than that of AUC(0.759,0.725)in patients with thyroid nodules diagnosed by NLR and PLR alone,and the sensitivity and specificity were significantly increased.Multivariate analysis showed that there was no significant correlation between TSH and postoperative treatment effect,but body mass index(BMI),NLR and PLR were independent risk factors for postoperative endocrine inhibition therapy for thyroid cancer(P<0.05).In ROC analysis,the cutoff value,sensitivity and specificity of NLR were 1.66,0.796 and 0.548respectively.For AUC=0.698 of PLR,the cutoff value was 159.656,the sensitivity was 0.926,the specificity was 0.466,the area under the curve was 0.70,the cutoff value was 24.78,the sensitivity was 0.759,and the specificity was 0.630.The NLR-PLR score in the ineffective group was significantly higher than that in the effective group(P<0.05).Conclusion:NLR,PLR and NLR-PLR are simple,effective and promising methods for predicting the efficacy of endocrine suppressi

关 键 词：中性粒细胞-淋巴细胞比率 血小板-淋巴细胞比率 甲状腺肿瘤 抑制治疗 

分 类 号：R736.1[医药卫生—肿瘤]