联合检测TC、HDL-C和NLR在乳腺纤维腺瘤筛查中的临床意义

Combined detection of TC,HDL-C and NRL for screening of breast fibroadenoma

目的探讨联合检测TC、HDL-C和中性粒细胞与淋巴细胞比值(NLR)在乳腺纤维腺瘤筛查中的临床意义。方法收集2018年1月至2021年10月浙江省中医院118例女性乳腺纤维腺瘤患者以及197名年龄匹配的女性健康对照者资料,对两组对象的血脂水平和部分肿瘤标志物进行统计学分析;使用二元logistic回归分析预测乳腺纤维腺瘤发生的危险因素;绘制ROC曲线评估各指标单独及联合检测筛查乳腺纤维腺瘤的效能。结果单因素统计分析显示,乳腺纤维腺瘤患者的TC、HDL-C、LDL-C、糖类抗原15-3(CA15-3)水平均低于健康对照组,NLR、癌胚抗原(CEA)、血小板与淋巴细胞比值(PLR)水平均明显高于健康对照组,差异均有统计学意义(均P<0.05);二元logistic回归分析结果显示,TC为乳腺纤维腺瘤的保护因素,HDL-C、NLR为乳腺纤维腺瘤的危险因素(均P<0.05);TC、NLR及3项指标联合检测的AUC分别为0.392、0.652、0.652、0.747,其中3项指标联合检测鉴别诊断乳腺纤维腺瘤的效能较好,其灵敏度和特异度分别为0.568、0.842。结论TC、HDL-C、NLR联合检测在乳腺纤维腺瘤的早期筛查中具有一定临床指导意义。

Objective To evaluation the combination of total cholesterol(TC),high density lipoprotein cholesterol(HDL-C)and neutrophil to lymphocyte ratio(NLR)for screening for breast fibroadenoma.Methods One hundred and eighteen patients with breast fibroadenoma and 197 age-matched healthy controls were enrolled in Zhejiang Provincial Hospital of Traditional Chinese Medicine from January 2018 to October 2021.The association of TC,HDL-C and NLR with breast fibroadenoma were analyzed with univariate and multivariate logistic regression;and their value for distinguishing breast fibroadenoma patients from normal subjects was analyzed by ROC curve.Results Univariate statistical analysis showed that the levels of TC,HDL-C,LDL-C and serum carbohydrate antigen 15-3(CA15-3)in patients with breast fibroadenoma were significantly lower than those in healthy controls.The levels of NLR,carcinoembryonic antigen(CEA)and platelet to lymphocyte ratio(PLR)were significantly higher than those in healthy controls(P<0.05).Multivariate logistic regression analysis showed that TC was a protective factor for breast fibroadenoma,while HDL-C and NLR were risk factors for breast fibroadenoma(P<0.05).The areas under the ROC curve(AUC)of TC,HDL-C,NLR and their combination for diagnosis of breast fibroadenoma were 0.392,0.652,0.652 and 0.747,respectively,and the sensitivity and specificity of combination of TC,HDL-C and NLR were 0.568 and 0.842 respectively.Conclusion The study indicates that combined detection of TC,HDL-C and NLR may be used in screening of breast fibroadenoma.