超声血流参数联合NLR、CA125、PLR对子宫内膜癌鉴别诊断价值

Differential diagnostic value of the ultrasound combined with the values of neutrophil/lymphocyte ratio and platelet/lymphocyte ratio,and the carbohydrate antigen 125 level of patients for their endometrial cancer

目的:探讨超声联合中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)NLR、糖类抗原125(CA125)对子宫内膜癌鉴别诊断价值。方法:收集2020年1月-2022年10月本院收治的子宫内膜癌患者92例为内膜癌组,子宫内膜良性病变患者82例为良性病变组,超声检测两组患者血流搏动指数(PI)、阻力指数(RI)、收缩期峰值流速(PSV),检测患者血清NLR、PLR、CA125水平,采用受试者工作特征(AUC)曲线分析各指标对子宫内膜癌鉴别诊断价值。结果:内膜癌组超声血流参数PSV高于对照组,PI、RI低于良性病变组,且内膜癌组Ⅲ-Ⅳ期患者PSV高于Ⅰ-Ⅱ期患者,PI、RI低于Ⅰ-Ⅱ期患者;血清CA125、NLR、PLR水平,内膜癌组均高于良性病变组,且内膜癌组Ⅲ-Ⅳ期患者高于Ⅰ-Ⅱ期患者(均P<0.05);ROC曲线分析显示,超声血流参数、CA125、NLR、PLR及联合应用鉴别诊断子宫内膜癌的曲线下面积分别为0.813、0.892,0.717、0.632、0.952,联合诊断效能最佳,敏感度98.2%。结论:超声血流参数,血清CA125、NLR、PLR在子宫内膜癌患者中发生异常,各指标联合应用对子宫内膜癌的鉴别诊断效力较高,有较好的临床指导价值。

Objective:To study the differential diagnostic value of the ultrasound combined with the values of neutrophil/lymphocyte ratio(NLR)and platelet/lymphocyte ratio(PLR),and the level of carbohydrate antigen 125(CA125)of patients for their endometrial cancer.Methods:92patients with endometrial cancer admitted to hospital from January 2020to October 2022were selected in study group,and 82patients with benign endometrial lesions were selected in control group during the same period.The values of blood flow pulsatility index(PI),resistance index(RI)and peak systolic velocity(PSV)of the patients in the two groups were detected by ultrasound.The NLR and PLR values and the serum level of CA125of the patients in the two groups were detected.Receiver operating characteristic(ROC)curve was used to analyze the values of above indexes of the patients for differential diagnosing their endometrial cancer.Results:The PSV value of the ultrasound blood flow parameters of the patients in the study group was significantly higher than that of the patients in the control group,but the values of PI and RI of the patients in the study group were significantly lower than those of the patients in the control group.The values of PSV of the ultrasound blood flow parameters of the patients with stageⅢ-Ⅳof endometrial cancer in the study group were significantly higher than that of the patients with stageⅠ-Ⅱof endometrial cancer,and the PI and RI values of the patients with stageⅢ-Ⅳof endometrial cancer were significantly lower than those of the patients with stageⅠ-Ⅱof endometrial cancer.The levels of serum CA125,NLR and PLR of the patients in the study group were significantly higher than those of the patients in the control group,and which of the patients with stageⅢ-Ⅳof endometrial cancer in the study group were significantly higher than that of the patients with stageⅠ-Ⅱof endometrial cancer(all P<0.05).ROC curve analysis showed that the area under the curve of the ultrasound blood flow parameters values,the CA125level,the NLR level,the PLR level and the combined ultrasound blood flow parameters values and the levels of the CA125,NLR and PLR of the patients for differential diagnosing their endometrial cancer were 0.813,0.892,0.717,0.632,and 0.952,respectively,and the combined ultrasound blood flow parameters values and the levels of the CA125,NLR and PLR of the patients for diagnosing their endometrial cancer had the best diagnostic efficiency,with a sensitivity of 98.2%.Conclusion:The ultrasound blood flow parameters values,and the CA125level,the NLR level and the PLR level of the patients with endometrial cancer are abnormal.The combined ultrasound blood flow parameters values and the levels of the CA125,NLR and PLR of the patients for diagnosing their endometrial cancer has higher differential diagnostic efficiency,which has better clinical guiding value.