摘要
目的探讨外周血中性粒细胞/淋巴细胞比值(NLR)、纤维蛋白原(FIB)在食管癌(EC)诊断中的价值,分析NLR、FIB与EC临床病理分期的关系。方法收集2017年6月至2020年6月徐州医科大学附属淮安医院收治的EC患者224例,EC癌前病变患者79例,胃-食管反流病(GERD)患者218例,另选取健康对照者214例。比较4组患者NLR、FIB、癌胚抗原(CEA)水平差异;利用受试者工作特征曲线(ROC)计算NLR、FIB、CEA诊断EC的曲线下面积(AUC),得出最佳截断值及敏感度与特异度;分析NLR、FIB、CEA水平与EC患者TNM分期的关系。结果EC组NLR、FIB明显高于EC癌前病变组、GERD组及对照组(P<0.05);EC组CEA明显高于GERD组及对照组(P<0.05),CEA在EC组与癌前病变组间比较,差异无统计学意义(P>0.05);EC癌前病变组NLR、FIB、CEA均高于对照组(P<0.05),与GERD组比较差异均无统计学意义(P>0.05);NLR、FIB、CEA 3个指标之中,只有NLR在GERD组和对照组间差异有统计学意义(P<0.05)。NLR、FIB、CEA诊断EC的AUC值分别为0.76、0.73、0.61,最佳截断值分别为2.48、2.75 g/L、2.06 ng/ml,敏感度分别为72.8%、65.3%、62.0%,特异度分别为64.3%、69.0%、59.2%,NLR、FIB诊断效力优于CEA(P<0.05),而NLR与FIB的诊断效力无明显差异(P>0.05)。NLR、FIB水平在不同的食管癌TNM分期中存在显著性差异(P<0.05)。经相关性分析,NLR、FIB、CEA均与食管癌分期呈正相关(r=0.25、0.19、0.19,P<0.05)。结论外周血NLR、FIB水平在EC患者中显著升高,NLR、FIB对EC的诊断效能优于CEA,NLR、FIB水平与EC的临床病理分期相关。
Objective To evaluate the value of neutrophil-to-lymphocyte ratio(NLR)and fibrinogen(FIB)in the diagnosis of esophageal cancer(EC),and analyze the relationship of NLR and FIB with clinicopathological stages of EC.Methods A total of 224 patients with EC,79 patients with precancerous EC lesions,and 218 patients with gastroesophageal reflux disease(GERD)were enrolled at Huai'an Hospital Affiliated to Xuzhou Medical University from June 2017 to June 2020,and 214 healthy controls were also included.The levels of NLR,FIB,and carcinoembryonic antigen(CEA)in the four groups were compared,and the areas under the receiver operating characteristic curves(AUCs)of NLR,FIB,and CEA in the diagnosis of EC were calculated,and the best cutoff value,sensitivity,and specificity were obtained.Finally,the relationship of the levels of NLR,FIB,and CEA with TNM stage in EC patients was analyzed.Results NLR and FIB in the EC group were significantly higher than those in the other three groups(P<0.05).CEA in the EC group was significantly higher than those in the GERD group and control group(P<0.05),but there was no significant difference in CEA between the EC group and precancerous lesion group(P>0.05).NLR,FIB,and CEA in the EC precancerous lesion group were significantly higher than those of the control group(P<0.05),but there was no statistical difference between EC precancerous lesion group and GERD group(P>0.05).Among the NLR,FIB,and CEA,only NLR showed a statistically significant difference between the GERD group and control group(P<0.05).The AUCs of NLR,FIB,and CEA in the diagnosis of EC were 0.76,0.73,and 0.61;the best cutoff values were 2.48,2.75 g/L,and 2.06 ng/ml;the sensitivities were 72.8%,65.3%,and 62.0%;and the specificities were 64.3%,69.0%,and 59.2%,respectively.The diagnostic efficacy of NLR and FIB was better than that of CEA(P<0.05),but there was no significant difference between NLR and FIB(P>0.05).The levels of NLR and FIB were significantly different among different TNM stages of EC(P<0.05).Correlation analysis showed that NLR,FIB,and CEA were positively correlated with EC stage(r=0.25,0.19,and 0.19,respectively,P<0.05).Conclusion NLR and FIB in peripheral blood significantly increase in patients with EC.The diagnostic efficacy of NLR and FIB in EC is better than that of CEA,and the levels of NLR and FIB correlate with the clinicopathological stage of EC.
作者
汪帅
李红玲
Wang Shuai;Li Hongling(Department of Gastroenterology,Huai'an Hospital Affiliated to Xuzhou Medical University,Huai'an 223001,China)
出处
《中华临床医师杂志（电子版）》
CAS
北大核心
2021年第5期365-369,共5页
Chinese Journal of Clinicians(Electronic Edition)
