外周血NLR、PLR、LMR在口腔鳞状细胞癌辅助诊断中的价值探讨

Discussion on auxiliary diagnostic value of NLR,PLR and LMR in OSCC

目的:探讨外周血中性粒细胞-淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板-淋巴细胞比值(platelet to lymphocyte ratio,PLR)、淋巴细胞-单核细胞比值(lymphocyte to monocyte ratio,LMR)在口腔鳞状细胞癌(oral squamous cell carcinoma,OSCC)辅助诊断中的价值及临床意义。方法:收集我院口腔颌面外科收治的OSCC 108例、口腔癌前病变95例、正常受试者100例,测量所有患者空腹血常规,通过中性粒细胞(neutrophils,NEUT)、淋巴细胞(lymphocytes,LYMPH)、单核细胞(monocytes,MONO)、血小板(platelets,PLT)数值计算出NLR、PLR、LMR,并进行统计学分析,对比分析OSCC患者NLR、PLR、LMR与淋巴结转移的关系。结果:OSCC、口腔癌前病变、正常受试者在性别比较上,差异有统计学意义,OSCC好发于男性(P=0.003),癌前病变患者性别差异无统计学意义(P>0.05)。3组患者在年龄、中性粒细胞、淋巴细胞、单核细胞、血小板、NLR、PLR、LMR上,差异无统计学意义(P>0.05)。OSCC患者NLR、PLR、LMR在淋巴结转移与否之间差异无统计学意义(P>0.05)。结论:NLR、PLR、LMR在OSCC淋巴结转移诊断中无显著作用,在疾病鉴别诊断中作用有限,临床医师应关注其他诊断方法,对口腔癌行早诊断、早治疗。

Objective:To investigate the auxiliary diagnostic value and clinical significance of peripheral blood neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),and lymphocyte to monocyte ratio(LMR)in oral squamous cell carcinoma(OSCC).Methods:Clinical data and fasting blood routine of 108 OSCC patients,95 oral precancerous lesions patients,and 100 normal patients were collected.Neutrophils(NEUT),lymphocytes(LYMPH),monocytes(MONO),platelets(PLT)were collected,NLR,PLR,LMR were analyzed statistically and the relationship with lymph node metastasis were investigated.Results:OSCC,oral precancerous lesions,and normal patients had significant difference in gender comparison.OSCC occurred more frequently in men(P=0.003),and there was no significant gender difference in patients with precancerous lesions(P>0.05);age,NEUT,LYMPH,MONO,PLT,NLR,PLR,LMR have no statistically significant difference among the three groups(P>0.05).NLR,PLR and LMR in patients with OSCC showed no significant difference in connection with lymph node metastasis(P>0.05).Conclusion:NLR,PLR,LMR demonstrate no auxiliary diagnostic value in lymph node metastasis,and has limited role in the differential diagnosis of the diseases.Clinicians should pay attention to other diagnostic methods so as to achieve early diagnosis and treatment of oral cancer.