外周血炎症生化指标与宫颈癌临床病理特征的关系探讨  

Relationship between biochemical indices of peripheral blood inflammation and clinicopathological features of cervical cancer

作　　者：高璐璐 李菡蕤 何滢 尚宇翔 张雅丽 哈春芳[3,4] GAO Lulu;LI Hanrui;HE Ying;SHANG Yuxiang;ZHANG Yali;HA Chunfang(Qingyang People′s Hospital,Qingyang 745000,China;Heze Municipal Hospital,Heze 274000,China;Department of Gynecology,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Key Laboratory of Fertility Maintenance of Ministry of Education,Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]庆阳市人民医院妇产科,甘肃庆阳745000 [2]菏泽市立医院妇产科,山东菏泽274000 [3]宁夏医科大学总医院妇科,宁夏银川750004 [4]宁夏医科大学生育力保持教育部重点实验室,宁夏银川750004

出　　处：《宁夏医学杂志》2025年第3期188-193,F0002,共7页Ningxia Medical Journal

基　　金：中央引导地方科技发展专项(2022FRD05034);宁夏重点研发计划项目(2023BEG01001)。

摘　　要：目的探讨外周血中鳞状上皮细胞癌抗原(SCC-Ag)、中性粒细胞/淋巴细胞(NLR)、血小板/淋巴细胞(PLR)、单核细胞/淋巴细胞(MLR)、纤维蛋白原/白蛋白(FAR)、血细胞比容(HCT)及D-二聚体与宫颈癌的临床病理特征之间的关系。方法收集宫颈癌患者210例,将其设为研究对象,年龄为25~80岁,平均年龄为(51.82±11.00)岁,根据2018版宫颈癌国际妇产科联盟(FIGO)分期,其中,早期宫颈癌即分期≤ⅡA期有132例,局部晚期及晚期宫颈癌即分期≥ⅡB期及ⅠB3期有78例;宫颈鳞癌有170例,非鳞癌有40例;宫颈高分化鳞状细胞癌有150例,非高分化鳞状细胞癌有60例。收集患者治疗前外周血中采用免疫化学发光法检测的SCC-Ag水平,收集使用全自动血液分析仪检测的外周血中中性粒细胞、血小板、单核细胞、淋巴细胞、纤维蛋白原、白蛋白、血细胞比容(HCT)、D-二聚体绝对值计数,以宫颈癌FIGO分期、组织类型、分化程度分组,采用SPSS 27.0分析以上生化指标与宫颈癌临床病理特征之间的相关性。采用受试者工作特征曲线(ROC)分析上述生化指标单独和联合对局部晚期及晚期宫颈癌的诊断效能。结果分期≥ⅡB期及ⅠB3期宫颈癌患者外周血的SCC-Ag、NLR、PLR、MLR、FAR、D-二聚体水平显著大于分期≤ⅡA期患者,HCT水平显著小于分期≤ⅡA期的患者(P<0.05)。SCC-Ag、NLR、PLR、MLR、FAR、D-二聚体水平与宫颈癌FIGO分期均呈正相关,HCT与宫颈癌FIGO分期呈负相关(P<0.05)。患者外周血中,鳞状细胞癌组患者SCC-Ag水平显著高于非鳞状细胞癌组(P<0.05)。ROC分析结果显示,SCC-Ag、NLR、PLR、MLR、FAR、HCT及D-二聚体单一指标预测分期≥ⅡB期及ⅠB3期宫颈癌的曲线下面积(AUC)分别为0.790、0.618、0.627、0.639、0.673、0.590、0.646,以上指标联合预测分期≥ⅡB期及ⅠB3期宫颈癌患者的AUC为0.865。结论宫颈癌患者治疗前外周血中的SCC-Ag及NLR、PLR、MLR、FAR�Objective To investigate squamous cell carcinoma antigen in peripheral blood relationship between antigen,neutrophil to lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),monocyte to lymphocyte ratio(MLR),fibrinogen to albumin ratio(FAR),hemocytometry volume(HCT)and D2 aggregates and clinical pathological features of cervical cancer.Methods A total of 210 cervical cancer patients,aged 25-80 years(51.82±11.00),were collected as the study subjects.According to the 2018 International Federation of Gynecology and Obstetrics(FIGO),there were 132 cases of early cervical cancer,that was in stage IIA.78 cases of locally advanced and advanced cervical cancer(≥IIB and IB3).There were 170 cases of cervical squamous carcinoma and 40 cases of non-squamous carcinoma.There were 150 cases of highly differentiated cervical cancer and 60 cases of non-differentiated cervical cancer.SCC-Ag levels in peripheral blood of patients before treatment were collected,and neutrophils,platelets,monocytes,lymphocytes,fibrinogen,albumin,Hematocrit(HCT)and D2 aggregates in peripheral blood were detected by automatic blood analyzer.Cervical cancer was grouped by FIGO stage,tissue type and degree of differentiation.The correlation between the above biochemical indicators and clinicopathological characteristics of cervical cancer were analyzed.The diagnostic efficacy of the above biochemical indices alone and in combination for locally advanced and advanced cervical cancer was analyzed.Results The levels of SCC-Ag,NLR,PLR,MLR,FAR and D2 in peripheral blood of patients with locally advanced and advanced cervical cancer were significantly higher than those of patients with≤IIA,while the HCT levels were significantly lower than those of patients with≤IIA(P<0.05).SCC-Ag,NLR,PLR,MLR,FAR,D2 polymers were positively correlated with FIGO staging of cervical cancer,while HCT was negatively correlated with FIGO staging of cervical cancer(P<0.05).SCC-Ag level in peripheral blood of patients in squamous cell carcinoma group was significantly higher th

关 键 词：局部晚期及晚期宫颈癌 SCC-AG 外周血炎症生化指标 

分 类 号：R711.74[医药卫生—妇产科学]