NLR、PLR与分化型甲状腺癌术后^(131)Ⅰ清甲效果的关系及其预测价值分析  

Relationship and Predictive Value of NLR,PLR with Postoperative^(131)I Thyroidectomy Efficacy in Differentiated Thyroid Cancer

作　　者：刘海娜[1] 王强[2] 何苗[1] 王朋 刘聪 孙源富 杨烁 王宇峰[1] LIU Hai-na;WANG Qiang;HE Miao;WANG Peng;LIU Cong;SUN Yuan-fu;YANG Shuo;WANG Yu-feng(Department of Nuclear Medicine,Xuzhou Cancer Hospital(Xuzhou Hospital Affiliated to Jiangsu University),Xuzhou,Jiangsu,221000,China;Department of Oncology Radiotherapy,Xuzhou Cancer Hospital(Xuzhou Hospital Affiliated to Jiangsu University),Xuzhou,Jiangsu,221000,China;Department of Puncture Minimally Invasive,Xuzhou New Healthy Geriatric Hospital(North Hospital of Xuzhou Cancer Hospital),Xuzhou,Jiangsu,221000,China)

机构地区：[1]徐州市肿瘤医院(江苏大学附属徐州医院)核医学科,江苏徐州221000 [2]徐州市肿瘤医院(江苏大学附属徐州医院)肿瘤放疗科,江苏徐州221000 [3]徐州市新健康老年病医院(徐州市肿瘤医院北院)穿刺微创科,江苏徐州221000

出　　处：《现代生物医学进展》2023年第22期4354-4358,共5页Progress in Modern Biomedicine

基　　金：江苏省青年医学重点人才资助课题(QNRC2016396)。

摘　　要：目的:探讨中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)与分化型甲状腺癌(DTC)术后碘131(^(131)Ⅰ)清甲治疗效果的关系及对DTC术后^(131)Ⅰ清甲效果的预测价值。方法:选择2019年3月至2021年12月在江苏大学附属徐州医院行甲状腺切除术且术后进行^(131)Ⅰ清甲治疗的DTC患者150例为研究对象,根据^(131)Ⅰ清甲治疗效果分为清甲成功组(107例)和清甲未成功组(43例),通过检查血常规获得中性粒细胞计数、血小板计数、淋巴细胞计数并计算NLR、PLR,比较两组NLR、PLR;采用单因素及多因素logistics回归模型分析^(131)Ⅰ清甲疗效的影响因素,采用受试者工作特征曲线(ROC)分析NLR、PLR对^(131)Ⅰ清甲治疗效果的预测价值。结果:清甲成功组NLR、PLR低于清甲未成功组(P<0.05),单因素分析显示清甲成功组促甲状腺激素(TSH)高于清甲未成功组,甲状腺球蛋白(Tg)水平低于清甲未成功组,清甲成功组病灶最大径小于清甲未成功组(P<0.05);多因素logistics回归分析显示,高NLR、PLR、Tg是^(131)Ⅰ清甲治疗失败的独立危险因素(P<0.05);NLR、PLR及联合检测预测^(131)Ⅰ清甲治疗效果的ROC曲线下面积(AUC)分别为0.760、0.732、0.829,NLR与PLR联合检测的AUC高于二者单独检测。结论:高NLR、PLR是DTC术后^(131)Ⅰ清甲未成功的独立危险因素,早期检测NLR、PLR对DTC术后^(131)Ⅰ清甲治疗效果具有较好的预测价值。Objective:To explore the relationship between neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR)and the treatment effect of iodine 131(^(131)I)thyroidectomy after operation for differentiated thyroid cancer(DTC)and the predictive value of the effect of^(131)I thyroidectomy after DTC operation.Methods:150 DTC patients who underwent thyroidectomy and underwent^(131)I thyroidectomy after operation in Xuzhou Hospital Affiliated to Jiangsu University from March 2019 to December 2021 were selected as the study subjects,and the patients were divided into successful thyroidectomy group(107 cases)and unsuccessful thyroidectomy group(43 cases)according to the effect of^(131)I thyroidectomy,neutrophil count,platelet count,lymphocyte count were obtained by blood routine examination and NLR and PLR were calculated,and the NLR and PLR were compared between the two groups.The influencing factors of^(131)I thyroidectomy efficacy was analyzed by single factor and multiple factor logistic regression model,and the predictive value of NLR and PLR on the efficacy of^(131)I thyroidectomy was analyzed by receiver operating characteristic curve(ROC).Results:The NLR and PLR in the successful thyroidectomy group were lower than those in the unsuccessful thyroidectomy group(P<0.05),single factor analysis showed that the levels of thyroid stimulating hormone(TSH)was higher than that in the unsuccessful thyroidectomy group,thyroglobulin(Tg)in the successful thyroidectomy group was lower than those in the unsuccessful thyroidectomy group,and the maximum diameter of the lesion in the successful thyroidectomy was smaller than that in the unsuccessful thyroidectomy group(P<0.05).Multivariate logistics regression analysis showed that,high NLR,PLR and Tg were independent risk factors for failure of^(131)I thyroidectomy(P<0.05).The area under ROC curve(AUC)of NLR,PLR and combined detection predicting the efficacy of^(131)I thyroidectomy was 0.760,0.732,0.829 respectively,and the AUC of NLR and PLR combined detection was higher than tha

关 键 词：分化型甲状腺癌 甲状腺全切除术 ^(131)Ⅰ清甲治疗 中性粒细胞/淋巴细胞比值 血小板/淋巴细胞比值 

分 类 号：R736.1[医药卫生—肿瘤]