摘要
目的探讨外周血中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)在早期胃癌诊断中的价值。方法选取2018-01/2019-01月在作者医院住院的75例早期胃癌患者为观察组,选取同时期75例健康体检者为对照组。采集观察组患者治疗前外周血及健康体检者外周血,统计所有研究对象外周血中性粒细胞和淋巴细胞计数,并计算NLR值;利用全自动电化学发光分析仪检测观察组患者血清糖类抗原72-4(carbohydrate antigen 72-4,CA72-4)水平。运用受试者工作特征曲线(receiver operating characteristic curve,ROC)分析NLR诊断胃癌的临界值、灵敏度和特异度;分析NLR、CA72-4及NLR联合CA72-4诊断早期胃癌的临床价值。结果观察组NLR和CA72-4水平均较对照组显著升高,差异具有统计学意义(P<0.05);观察组患者中NLR的阳性检出率明显高于CA72-4的阳性检出率,差异具有统计学意义(P<0.05);NLR诊断胃癌的灵敏度为0.77,特异度为0.73,约登指数为0.50;CA72-4诊断胃癌的灵敏度为0.73,特异度为0.65,约登指数为0.38;NLR联合CA72-4诊断胃癌的灵敏度为0.84,特异度为0.77,阳性似然比为3.65,阴性似然比为0.21,约登指数为0.61;NLR联合CA72-4诊断胃癌在灵敏度和特异度等方面优于单独使用CA72-4,差异具有统计学意义(P<0.05)。结论 NLR在早期胃癌的诊断中具有一定的价值,NLR联合CA72-4有助于提高早期胃癌诊断的灵敏度和特异度。
Objective To explore the value of neutrophil to lymphocyte ratio(NLR) in the diagnosis of early gastric cancer. Methods A total of 75 patients with early gastric cancer admitted to the author’s hospital from January 2018 to January 2019 were selected as the observation group,and 75 cases of normal people were selected as control group. The peripheral blood were collected from subjects in two groups,and the counts of neutrophils(N) and lymphocytes(L) in peripheral blood of all subjects were counted, and the NLR(NLR=N/L) was calculated.The serum carbohydrate antigen 72-4(CA72-4) level of patients in the observation group was detected by automatic electrochemical luminescence analyzer. The critical value, sensitivity and specificity of NLR in diagnosing gastric cancer were analyzed by receiver operating characteristic curve(ROC).The clinical value of NLR, CA72-4 and NLR combined with CA72-4 in the diagnosis of early gastric cancer were analyzed. Results NLR and CA72-4 levels in the observation group were significantly higher than those in the control group(P<0.05).The positive detection rate of NLR in the observation group was significantly higher than that of CA72-4(P<0.05). The sensitivity, specificity and youden index of NLR in the diagnosis of gastric cancer were 0.77, 0.73 and 0.50, respectively. The sensitivity, specificity and youden index of CA72-4 in the diagnosis of gastric cancer were 0.73, 0.65 and 0.38, respectively. The sensitivity, specificity,positive likelihood ratio,negative likelihood ratio and youden index of NLR combined with CA72-4 in the diagnosis of gastric cancer were 0.84, 0.77, 3.65, 0.21 and 0.61, respectively. The sensitivity and specificity of NLR combined with CA72-4 in the diagnosis of gastric cancer were better than those of CA72-4 alone(P<0.05). Conclusion NLR has certain value in the diagnosis of early gastric cancer, and the combination of NLR with CA72-4 is helpful to improve the sensitivity and specificity of the diagnosis of early gastric cancer.
作者
李亚娟
郑运周
刘培红
刘秀红
LI Yajnan;ZHENG Yunzhou;LIU Peihong;LIU Xiuhong(Department of Clinical Laboratory,NO.980 Hospital of Joint Logistics Support Force of People's Liberation Army,Shijiazhuang Hebei 050082,China)
出处
《华南国防医学杂志》
CAS
2019年第11期744-747,共4页
Military Medical Journal of South China
基金
北京市自然科学基金面上项目(7182066)
