碱性磷酸酶联合钙离子及总胆红素对声带肿物良恶性的诊断价值  

Value of Alkaline Phosphatase Combined with Calcium and Total Bilirubin in Diagnosis of Benign and Malignant Vocal Cord Masses

作　　者：周凡 曹峰[1] 胡燕明 ZHOU fan;CAO Feng;HU Yanming(Department of Otorhinolaryngology,the Second People′s Hospital of Hefei,Hefei 230000,China;Department of Otorhinolaryngology,the First Affiliated Hospital of University of Science and Technology of China,Hefei 230001,China)

机构地区：[1]合肥市第二人民医院安徽医科大学附属合肥医院耳鼻喉科,合肥230000 [2]中国科学技术大学附属第一医院耳鼻喉科,合肥230001

出　　处：《医学综述》2022年第19期3945-3949,共5页Medical Recapitulate

摘　　要：目的探讨碱性磷酸酶联合钙离子及总胆红素对声带肿物良恶性的诊断价值。方法选取2017年1月至2020年11月合肥市第二人民医院联合中国科学技术大学附属第一医院收治的以声音嘶哑为首发症状的声带肿物患者120例,患者均行支撑喉镜下CO_(2)激光显微手术治疗,根据术后病理组织学检查结果分为良性组(48例)和恶性组(72例)。采集患者空腹静脉血进行血常规[中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)]、碱性磷酸酶(ALP)、血清钙离子、总胆红素(TBil)等检测,比较两组ALP、血清钙离子、TBil水平,绘制受试者工作特征曲线(ROC曲线),评价ALP、血清钙离子、TBil水平单项或联合检测对声音嘶哑患者声带肿物良恶性的诊断效能。结果两组NLR、PLR水平比较差异无统计学意义(P>0.05)。恶性组ALP、血清钙离子及TBil水平均高于良性组[(146.8±5.0)U/L比(95.7±4.6)U/L、(3.05±0.48)mmol/L比(2.38±0.27)mmol/L、(7.81±1.55)mg/L比(4.54±0.53)mg/L](均P<0.01)。受试者工作特征曲线显示,ALP、血清钙离子、TBil三者联合诊断声音嘶哑患者声带肿物良恶性的ROC曲线下面积显著高于其他三项单项检测(Z=-3.415,P=0.012;Z=-2.479,P=0.027;Z=-2.157,P=0.035),三项联合检测诊断的灵敏度和特异度分别为91.28%、90.77%。结论ALP、血清钙离子、TBil水平三项联合检测可作为临床诊断声带恶性肿瘤的重要指标,降低误诊或漏诊率,从而为临床治疗提供有效的依据。Objective To discuss the value of alkaline phosphatase combined with calcium and total bilirubin in the diagnosis of benign and malignant vocal cord masses.Methods A total of 120 patients with vocal cord mass with hoarseness as the first symptom from the Second People′s Hospital of Hefei and the First Affiliated Hospital of University of Science and Technology of China from Jan.2017 to Nov.2020 were included.All patients were treated with CO_(2) laser microsurgery under supported laryngoscope.According to the results of postoperative histopathology,the patients were divided into a benign group(48 cases)and a malignant group(72 cases).Fasting venous blood was collected from the patients for blood routine[neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)],alkaline phosphatase(ALP),serum calcium,total bilirubin(TBil)and other tests.ALP,serum calcium,and TBil levels were compared between the two groups,and the receiver operating characteristic(ROC)curves were drawn,to evaluate the diagnostic efficacy of ALP,serum calcium and TBil levels for benign and malignant vocal cord masses in patients with hoarseness.Results There was no significant difference in NLR and PLR levels between the two groups(P>0.05).The levels of ALP,serum calcium and TBil in the malignant group were higher than those in the benign group[(146.8±5.0)U/L vs(95.7±4.6)U/L,(3.05±0.48)mmol/L vs(2.38±0.27)mmol/L,(7.81±1.55)mg/L vs(4.54±0.53)mg/L](all P<0.01).The ROC curved showed that area under the ROC curve of combined ALP,serum calcium and TBil was significantly higher than the other three single tests in the diagnosis of benign and malignant vocal cord masses in patients with hoarseness(Z=-3.415,P=0.012;Z=-2.479,P=0.027;Z=-2.157,P=0.035),and the sensitivity and specificity of the three combined test were 91.28%and 90.77%,respectively.Conclusion The combined detection of ALP,serum calcium and TBil levels can be used as an important indicator for the clinical diagnosis of vocal cord malignant tumor,to reduce the rate of misdi

关 键 词：声带肿物 声音嘶哑 碱性磷酸酶 血清钙离子 总胆红素 

分 类 号：R767.4[医药卫生—耳鼻咽喉科]