术前中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值对阴茎癌腹股沟淋巴结转移的预测价值  

Predictive value of preoperative NLR and PLR for inguinal lymph node metastasis of penile cancer

作　　者：李健[1] 郭雯静 孙忠忠 武进峰[1] LI Jian;GUO Wenjing;SUN Zhongzhong;WU Jinfeng(Department of Urology,The Third Hospital of Shanxi Medical University,Shanxi Bethune Hospital,Shanxi Academy of Medical Sciences,Tongji Shanxi Hospital,Taiyuan 030032;School of Public Health,Shanxi Medical University,Taiyuan 030001,China)

机构地区：[1]山西医科大学第三医院(山西白求恩医院,山西医学科学院,同济山西医院)泌尿外科,山西太原030032 [2]山西医科大学公共卫生学院,山西太原030001

出　　处：《现代泌尿外科杂志》2024年第1期56-59,共4页Journal of Modern Urology

摘　　要：目的 分析术前中性粒细胞与淋巴细胞比值(NLR)及血小板与淋巴细胞比值(PLR)对阴茎癌腹股沟淋巴结转移的预测价值,为临床评估提供新思路。方法 回顾性分析2016年1月—2021年12月于山西白求恩医院泌尿外科接受手术治疗的48例阴茎癌患者,依据是否发生腹股沟淋巴结转移分为转移组(n=19)和未转移组(n=29)。记录患者中性粒细胞、淋巴细胞及血小板数,计算NLR、PLR。应用受试者工作特征曲线(ROC)分析NLR、PLR预测阴茎癌腹股沟淋巴结转移的价值。Pearson相关性分析检测NLR、PLR间的相关性。结果 转移组NLR和PLR水平均明显高于未转移组(P<0.01)。ROC曲线显示NLR最佳截断值为2.39,AUC为0.838(95%CI:0.730~0.947),灵敏度和特异度分别为94.7%和58.6%;PLR最佳截断值为113.66,AUC为0.755(95%CI:0.618~0.892),灵敏度和特异度分别为89.5%和58.6%。两项联合诊断的AUC为0.851(95%CI:0.747~0.956),灵敏度和特异度分别为89.5%和69.0%。Pearson相关分析显示,转移组与未转移组患者的NLR与PLR均呈正相关(r=0.504,r=0.645,均有P<0.05)。结论 阴茎癌患者术前NLR、PLR水平显著升高并且通过两项指标联合诊断在一定程度上预示着患者存在腹股沟淋巴结转移的可能。Objective To explore the value of preoperative neutrophil-to-lymphocyte ratio(NLR) and platelet-to-lymphocyte ratio(PLR) in the prediction of inguinal lymph node metastasis of penile cancer to provide a new idea for the clinical evaluation.Methods A total of 48 patients with penile cancer who received surgical treatment in our hospital during Jan.2016 and Dec.2021 were selected and divided into the metastatic group(n=19) and non-metastatic group(n=29).The number of neutrophils,lymphocytes and platelets were recorded,and NLR and PLR were calculated.The value of NLR and PLR in predicting inguinal lymph node metastasis was analyzed with receiver operating characteristic(ROC) curve.The correlation between NLR and PLR was determined with Pearson correlation analysis.Results The levels of NLR and PLR were significantly higher in the metastatic group than in the non-metastatic group(P<0.05).ROC curve showed that the optimal cut-off value of NLR was 2.39,the area under the ROC curve(AUC) was 0.838(95%CI:0.730-0.947),with sensitivity of 94.7% and specificity of 58.6%,respectively.The optimal cut-off value of PLR was 113.66,the AUC was 0.755(95%CI:0.618-0.892),with sensitivity of 89.5% and specificity of 58.6%,respectively.The AUC of the two combined together was 0.851(95%CI:0.747-0.956),with sensitivity of 89.5% and specificity of 69.0%.The Pearson correlation analysis showed that NLR was positively correlated with PLR in patients in both groups(r=0.504,r=0.645,P<0.05).Conclusion Preoperative NLR and PLR levels are significantly increased in patients with penile cancer,and the combination of the two indexes can predict the possibility of inguinal lymph node metastasis.

关 键 词：阴茎癌 腹股沟淋巴结转移 炎症因子 中性粒细胞 淋巴细胞 血小板 

分 类 号：R699.8[医药卫生—泌尿科学]