摘要
目的探讨外周血炎症指标与肿瘤标志物在食管癌不同T分期中的差异表达特征,并分析其对食管癌T分期诊断的价值。方法回顾性分析2024年1月至2025年1月在安阳市肿瘤医院确诊并收治的100例食管癌患者的临床及实验室资料。依据患者的T分期分为T1~T2期组(n=62)和T3~T4期组(n=38),对比患者外周血炎症指标和肿瘤标志物表达水平差异,采用方差膨胀因子(VIF)检测多重共线性,纳入非共线性变量进行多因素Logistic回归分析,筛选T分期的独立影响因素,并利用受试者工作特征曲线(ROC)评估其单项及联合诊断价值。结果T3~T4期患者的血小板计数(PLT)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、系统性免疫炎症指数(SⅡ)、C反应蛋白(CRP)、血清淀粉样蛋白A(SAA)、纤维蛋白原(FIB)以及鳞状细胞癌相关抗原(SCC-Ag)、细胞角蛋白19片段(CYFRA21-1)和糖类抗原19-9(CA19-9)水平均显著高于T1~T2期(P<0.05)。共线性诊断后删除NLR、PLR和PLT,其余指标进行多因素Logistic分析。多因素Logistic分析结果显示SⅡ和CYFRA21-1为T3~T4分期的独立影响因素。ROC分析显示,SⅡ与CYFRA21-1单独诊断T3~T4期的AUC值分别为0.892和0.868,而二者联合AUC值达0.928,灵敏度与特异度均更高。结论外周血炎症指标和肿瘤标志物在食管癌不同T分期中具有显著差异,SⅡ和CYFRA21-1是晚期T分期的独立影响因素,二者联合检测或有助于提高食管癌T分期的诊断效能。
Objective To investigate differential expression patterns of peripheral blood inflammatory indicators and tumor markers across different T stages of esophageal cancer and to evaluate their value in diagnosing T stage in patients with esophageal cancer.Methods Clinical and laboratory data of 100 patients with esophageal cancer diagnosed and treated at Anyang Cancer Hospital between January 2024 and January 2025 were retrospectively analyzed.According to T stage.patients were divided into a T1~T2 group(n=62)and a T3~T4 group(n=38).Levels of peripheral blood inflammatory indicators and tumor markers were compared between the two groups.Variance inflation factor(VIF)was used to assess multicollinearity.and non-collinear variables were entered into multivariable Logistic regression analysis to identify independent factors associated with T stage.Receiver operating characteristic(ROC)curves were constructed to evaluate the diagnostic performance of individual indicators and their combination.Results Compared with the T1~T2 group.patients in the T3~T4 group had significantly higher platelet count(PLT).neutrophil-to-lymphocyte ratio(NLR).platelet-to-lymphocyte ratio(PLR).systemic immuneinflammation index(SⅡ).C-reactive protein(CRP).serum amyloid A(SAA).fibrinogen(FIB).and the tumor markers squamous cell carcinoma antigen(SCC-Ag).cytokeratin 19 fragment(CYFRA21-1).and carbohydrate antigen 19-9(CA19-9)(P<0.05).After collinearity assessment.NLR.PLR.and PLT were excluded.and the remaining indicators were included in the multivariable Logistic regression analysis.The results showed that SⅡand CYFRA21-1 were independent risk factors for T3~T4 stage.ROC analysis indicated that the areas under the curve(AUC)for SⅡand CYFRA21-1 in diagnosing T3~T4 stage were 0.892 and 0.868.respectively.whereas the combined AUC reached 0.928.with higher sensitivity and specificity.Conclusion Peripheral blood inflammatory indicators and tumor markers differ significantly across T stages in esophageal cancer.SⅡand CYFRA21-1 are independent indicators for advanced T stage.and their combined assessment may help improve the diagnostic performance for T staging in esophageal cancer.
作者
苏熙
王艳敏
SU Xi;WANG Yanmin(Department of Laboratory Medicine,Anyang Cancer Hospital,Anyang Henan 455000,China)
出处
《临床研究》
2026年第2期20-23,共4页
Clinical Research
