血小板计数和血沉及乳酸脱氢酶检测对诊断肺癌的意义

Diagnostic Significance of Platelet Count, Erythrocyte Sedimentation Rate and Lactate Dehydrogenase in Patients with Lung Cancer

目的 结合血小板计数 (PLT)、血沉 (ESR)和乳酸脱氢酶 (LDH)判断X线检查表现为肺部肿块、怀疑为肺癌病变的良恶性。方法 回顾性分析了 15 4例X线检查表现为肺部肿块、怀疑为肺癌的病人资料 ,其中 ,肺癌 75例 ,肺部良性病变 79例。分析PLT ,ESR和LDH异常和肺癌间的关系 ,统计学处理采用计数资料的 χ2 检验。结果PLT计数增多 ,ESR加快和LDH升高对怀疑为肺癌病变的良恶性判断都有意义 ,但是 ,敏感性和特异性较低。将PLT ,ESR和LDH三者结合起来考虑 ,敏感性和阴性预测价值分别达到了 0 6 9、0 77,特异性和阳性预测价值都是1 0 0。结论 对X线检查怀疑肺癌的病人应常规行PLT、ESR和LDH检查 ,将三项结果联合起来考虑 。

Objective To evaluate the clinical value of an elevated platelet count (PLT),erythrocyte sedimentation rate (ESR) and lactate dehydrogenase (LDH) for predicting malignancy in patients with radiologically suspected lung cancer.Methods PLT,ESR and LDH were analysed in 154 prospectively admitted patients with suspected lung cancer.The patients were divided by pathologic diagnosis into those with benign disorders (n=79) and with lung cancer (n=75).Patients with lung cancer were staged (TNM) and the tumours were classified according to histological types (WHO).Results Thrombocytosis (platelet count>300×10 9/L) was present in 13% (10/79) of patients with benign disease and in 57% (43/75) of patients with lung cancer.No difference was observed in histological types.The sensitivity of thrombocytosis for predicting malignancy was 0.57 and the specificity 0.87.When PLT, LDH and ESR were combined, a sensitivity of 0.69 and a specificity of 1.00 were attained.The positive and negative predictive values were 1.00 and 0.77,respectively.Conclusions When the test results of PLT,ESR and LDH are combined,a high sensitivity and specificity for predicting malignancy can be attained.These tests are clinically useful in the evaluation of patients with radiologically suspected lung cancer.