ESR、血沉方程K值、Fbg、hs-CRP及GLB水平变化用于筛查鼻咽癌的价值初探

The value of the level wave of ESR,ESRK,fibrinogen,high sensitivity C-reactive protein and globulin on screening nasopharyngeal carcinoma

目的观察鼻咽癌(nasopharyngeal carcinoma,NPC)和鼻咽炎(nasopharyngitis,Npi)患者红细胞沉降率(e-rythrocyte sedimentation rate,ESR)、血沉方程K值(equation K value of erythrocyte sedimentation rate,ESRK)、纤维蛋白原(fibrinogen,Fbg)、超敏C反应蛋白(high sensitivity C-reactive protein,hs-CRP)及球蛋白(globulin,GLB)水平及其相互之间关系,探讨其用于鉴别二者的潜在价值。方法收集经病理组织学确诊的下列患者血液标本:Npi 30例,NPC 61例,检测其ESR、Hct、Fbg、hs-CRP及GLB水平,并计算得到ESRK,分析各变量在两种疾病之间的变化。结果 (1)除GLB外,NPC组各指标总体水平均高于Npi组,其中Fbg和hs-CRP差异显著(P<0.05),但此二指标中位水平仍未超过参考值上限。(2)将NPC各期分别与Npi比较,发现Fbg和hs-CRP在NPC早期即明显升高(P<0.05),二者呈正相关(P<0.05),而ESR和ESRK在肿瘤晚期显著升高(P<0.05),二者也呈正相关(P<0.05)。结论 Fbg和hs-CRP对NPC的预警价值高于ESR和ESRK,但目前的参考值体系限制了二者在预测NPC上的应用。

Objective To explore the potential value of erythrocyte sedimentation rate（ESR）,equation K value of erythrocyte sedimentation rate（ESRK）,fibrinogen（Fbg）,high sensitivity C-reactive protein（hs-CRP） and globulin（GLB） on differentiating nasopharyngeal carcinoma（NPC） from nasopharyngitis（Npi）.Methods Blood samples from 61 NPC and 30 Npi patients,which had been certified by pathology,were collected and tested following parameters： ESR,Fbg,hs-CRP and GLB.ESRK was taken by calculation.Results（1） All general median of above parameters except GLB were higher in NPC group than that in Npi group,among them only the medians of Fbg and hs-CRP were significantly higher（P〈0.05）,but still in the permission field of the reference values.（2）Comparing above parameters between Npi and various stages of NPC,Fbg and hs-CRP were significant higher at early NPC stage（ⅠandⅡ） than those in Npi（P〈0.05）,and positive correlation existed in both parameters（P〈0.05）;while ESR and ESRK markedly increased at late NPC stage（Ⅲand Ⅳ）（P〈0.05）,and also positive correlation was found in both parameters（P〈0.05）.Conclusion Fbg and hs-CRP might be hopeful,cheap and convenient candidates on early warning NPC,but clinical use of both was limited by current reference values which covered up their differences between NPC and Npi.