摘要
目的探讨外周血细胞和肿瘤标志物在非小细胞肺癌(NSCLC)早期诊断、病情判断和预后评估中的意义。方法选取2018年1月至2019年12月在该院住院治疗的经组织病理学确诊的NSCLC患者131例(NSCLC组)作为研究对象。另选取同期在该院体检的健康者70例作为对照组,检测两组研究对象的外周血细胞和肿瘤标志物水平并进行比较。结果与对照组相比,NSCLC组白细胞、中性粒细胞、单核细胞、血小板(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)、细胞角蛋白19片段(CYFRA21-1)、癌胚抗原(CEA)、神经元特异性烯醇化酶(NSE)明显升高,而NSCLC组淋巴细胞、淋巴细胞与单核细胞比值(LMR)明显降低,差异有统计学意义(P<0.05)。NSCLC组中腺癌患者白细胞、中性粒细胞、单核细胞、CYFRA21-1水平与鳞癌患者相比均明显降低,差异有统计学意义(P<0.05)。与对照组相比,NSCLC组Ⅰ期患者白细胞、中性粒细胞、NLR、PLR明显升高,而LMR明显降低,差异有统计学意义(P<0.05)。将NLR、PLR、LMR、CYFRA21-1、CEA、NSE进行受试者工作特征曲线(ROC曲线)分析,结果显示NLR的ROC曲线下面积、灵敏度、约登指数较高,6项指标联合检测的临床诊断效能最佳。结论外周血细胞与NSCLC的临床分期及病理分型关系密切,外周血细胞与肿瘤标志物的联合检测的临床诊断效能较高,可以为NSCLC的早期诊断和病情严重程度和预后的评估提供新的思路。
Objective To explore the significance of peripheral blood cells and tumor markers in the early diagnosis,disease judgment and prognosis evaluation of non-small cell lung cancer(NSCLC).Methods A total of 131 histopathologically confirmed NSCLC patients(NSCLC group)hospitalized in this hospital from January 2018 to December 2019 were selected as the study subjects.In addition,70 healthy subjects who underwent physical examination in the hospital during the same period were selected as the control group,and the levels of peripheral blood cells and tumor markers of the two groups were detected and compared.Results Compared to the control group,leukocytes,neutrophils,monocytes,platelets(PLT),neutrophils to lymphocyte ratio(NLR),platelets to lymphocyte ratio(PLR),cytokeratin 19 fragment antigen 21-1(CYFRA21-1),carcinoembryonic antigen(CEA)and neuron specific enolase(NSE)were significantly increased in NSCLC group,while the ratio of lymphocyte and lymphocyte to monocyte(LMR)in NSCLC group was significantly decreased,the difference was statistically significant(P<0.05).The levels of white blood cells,neutrophils,monocytes and CYFRA21-1 in patients with adenocarcinoma in NSCLC group were significantly lower than those in patients with squamous cell carcinoma,with statistical significance(P<0.05).Compared with the control group,leukocytes,neutrophils,NLR and PLR in NSCLC group stageⅠwere significantly increased,while LMR was significantly decreased,with statistical significance(P<0.05).The receiver operating characteristic curve(ROC curve)of NLR,PLR,LMR,CYFRA21-1,CEA and NSE were analyzed.The results showed that the area under ROC curve,sensitivity and Youden index of NLR were higher,and the combined detection of the six indexes had the best clinical diagnostic efficacy.Conclusion There is a close relationship between peripheral blood cells and clinical stage and pathological classification of NSCLC,and the combined detection of peripheral blood cells and tumor markers has a high clinical diagnostic efficiency,which can provide a new idea for the early diagnosis of NSCLC and the evaluation of disease severity and prognosis.
作者
张利改
何远
陈鸣
吴宇
ZHANG Ligai;HE Yuan;CHEN Ming;WU Yu(Department of Clinical Laboratory,the First Affiliated Hospital of Army Medical University,Chongqing 400038,China)
出处
《国际检验医学杂志》
CAS
2022年第14期1665-1670,1674,共7页
International Journal of Laboratory Medicine
基金
国家自然科学基金重点项目(82030066)。
关键词
外周血细胞
肿瘤标志物
非小细胞肺癌
peripheral blood cells
tumor markers
non-small cell lung cancer
作者简介
张利改,女,主管技师,主要从事感染免疫和肿瘤免疫相关研究;通信作者:吴宇,E-mail:594190699@qq.com。
