血NLR、PLR和LMR检测对老年肺癌的诊断效能研究

Diagnostic efficacy of serum NLR,PLR and LMR in elderly patients with lung cancer

中文关键词: 老年  肺癌  中性粒细胞与淋巴细胞比值  血小板与淋巴细胞比值  淋巴细胞与单核细胞比值

英文关键词: elderly  lung cancer  neutrophil to lymphocyte ratio  platelet to lymphocyte ratio  lymphocyte to monocyte ratio

中文摘要:

      目的 探索老年肺癌患者的血中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、淋巴细胞与单核细胞比值(LMR)单独检测及联合检测对肺癌的诊断效能.方法 收集2021 年1 月1 日—2022 年12 月31 日于梅州市人民医院的患者的临床资料,筛选出首次诊断为肺癌患者 232 例(设为肺癌组),选择同期年龄匹配的健康体检者 232例(设为健康对照组).对2 组临床资料进行回顾性分析与比较.结果 肺癌组血NLR、PLR、癌胚抗原(CEA)、细胞角蛋白19 片段(CYFRA21-1)水平高于健康对照组,而LMR水平低于健康对照组,差异均有统计学意义(P＜0.05).肺癌组NLR＞3.0 占比36.21%、PLR≥200 占比27.59%,LMR＜3 占比 41.81%,CEA＞5.0 占比 32.76%,CYFRA21-1≥3.3 占比25.86%,均高于健康对照组的6.47%、6.90%、5.60%、11.21%、10.34%,差异均有统计学意义(P＜0.05).肺癌组中Ⅱ期、Ⅲ期和Ⅳ期患者NLR、PLR水平均高于Ⅰ期患者,而Ⅱ期和Ⅳ期患者LMR水平低于Ⅰ期患者,差异均有统计学意义(P＜0.05).NLR、PLR、LMR、CEA、CYFRA21-1 对诊断肺癌的AUC分别为0.782、0.790、0.691、0.707、0.682,且NLR、PLR的AUC值均高于CEA和CYFRA21-1,差异均有统计学意义(P＜0.05);LMR的AUC值与CEA和CYFRA21-1 比较,差异无统计学意义(P＞0.05).炎性标志物NLR、PLR、LMR三项指标联合检测的AUC值为0.792,特异度高达0.893,均高于单项指标,但其灵敏度却低于PLR、LMR单项指标.炎性标志物联合肿瘤标志物CEA、CY-FRA21-1 的AUC值上升至0.830(P＜0.05),且灵敏度提高.结论 NLR、PLR、LMR与肺癌的发病相关,对肺癌的诊断有一定的预测价值,并且与肺癌的临床分期相关,可辅助肺癌诊断.

英文摘要:

      Objective To explore the diagnostic efficacy of single and combined detection of serum neutrophil to lym? phocyte ratio (NLR), platelet to lymphocyte ratio (PLR) and lymphocyte to monocyte ratio (LMR) in elderly patients with lung cancer. Methods The clinical data of patients who visited People??s Hospital of Meizhou City from January 1, 2021 to December 31, 2022 were collected. A total of 232 patients diagnosed with lung cancer for the first time (lung cancer group) were selected, and 232 age?matched healthy physical examination subjects (healthy control group) were selected during the same period. The clinical data of the two groups were retrospectively analyzed and compared. Results The levels of serum NLR, PLR, carcinoembryonic antigen (CEA) and cytokeratin 19 fragment (CYFRA21?1) of the lung cancer group were high? er than those of the healthy control group, while LMR level was lower than that of the healthy control group, with statistically significant differences (P <0. 05). The proportions of NLR >3. 0, PLR≥200, LMR <3, CEA >5. 0 and CYFRA21?1≥3?? 3 in the lung cancer group were 36. 21% , 27. 59% , 41. 81% , 32. 76% and 25. 86% , respectively, and they were higher than those in the healthy control group (6. 47% , 6. 90% , 5. 60% , 11. 21% , 10. 34% ; P <0. 05). In the lung cancer group, the levels of NLR and PLR in patients at stage II, III and IV were higher than those at stage I, while LMR level in patients at stage II and IV was lower than that at stage I, with statistical significances (P < 0. 05). The AUC of NLR, PLR, LMR, CEA and CYFRA21?1 for diagnosing lung cancer were 0. 782, 0. 790, 0. 691, 0. 707 and 0. 682, respectively, and the AUC of NLR and PLR were greater than those of CEA and CYFRA21?1, with statistical significances (P <0. 05). The AUC of LMR was not significantly different from that of CEA and CYFRA21?1 (P >0. 05). The AUC of the combined detection of inflam? matory markers (NLR, PLR and LMR) was 0. 792 and the specificity was 0. 893, which were higher than those of the single index, but the sensitivity was lower than that of the single index of PLR and LMR. The AUC of inflammatory markers combined with tumor markers (CEA and CYFRA21?1) increased to 0. 830 (P <0. 05), and the sensitivity increased. Conclusion NLR, PLR and LMR are related to the development of lung cancer, have certain predictive value for the diagnosis of lung cancer, and are related to the clinical staging of lung cancer, and can assist the diagnosis of lung cancer.