NLR联合T-PSA检测在前列腺癌诊断中的应用价值

The value of NLR combined T-PSA in the diagnosis of prostate cancer

目的探索β2微球蛋白(β2M)、乳酸脱氢酶(LDH)及中性淋巴比率(NLR)与前列腺癌的关系及其变化规律,寻找一种或几种能提高前列腺癌诊断灵敏度及特异度的标志物,为临床对前列腺癌的诊断、治疗及预后提供帮助。方法随机选取本院收治的149例前列腺癌患者,40例前列腺增生患者及83例健康体检者为研究对象。分别对入选者采血标本进行总前列腺特异性抗原(T-PSA)、游离前列腺特异性抗原(F-PSA)、β2M、LDH及NLR的测定,比较其在各组间的分布,寻找一种或几种能提高前列腺癌诊断灵敏度及特异度的标志物,寻找其最佳的cut-off值,进一步分析此标志物在前列腺癌不同临床分期及不同Gleason评分间的差异,寻找其与前列腺癌之间的相关性。结果 T-PSA在前列腺良恶性疾病中均有增高,而NLR仅在前列腺癌患者中增高;通过受试者工作特征(ROC)曲线分析得到T-PSA的最佳cut-off值为4. 625 ng/ml,NLR的最佳cut-off值为2. 11,二者联合可以提高诊断的特异度;前列腺癌不同NLR的患者Gleason评分比较差异有统计学意义(P=0. 030)。结论 NLR联合T-PSA可以提高T-PSA单独诊断前列腺癌的特异度,并且NLR与前列腺癌患者的预后存在一定的相关性。

Objective The aim of our study was to explore the relationship between prostate cancer and four serum markers, including Prostate specific antigen (PSA), Beta 2 Microglobulin (β2M), Neutrophil-to-lympochyte ratio (NLR) and Lactic dehydrogenase (LDH), and their variation rules in development of prostate cancer. Then to find one or more markers that can increase the sensitivity and specificity of diagnosis to provide reference for clinic. Methods A total of 149 prostate cancer patients, 40 patients with benign prostatic hyperplasia, 80 healthy subjects in our hospital were analyzed, and subsequent the T-PSA, F-PSA, β2M, LDH and NLR were measured. The correlation between these markers and prostate cancer as well as its different types and Gleason score was assessed statistically. We determined the cut-off point of the NLR and T-PSA according to the specificity and sensitivity levels derived from area under receiver operator characteristic (ROC) curve. Results The level of T-PSA was significantly higher in patients of prostate cancer and benign prostatic hyperplasia, and the level of NLR was higher only in patients of prostate cancer. Based on the area under ROC, the cut-off value of T-PSA was determined to be 4.625 ng/ml, and NLR was 2.11, and combined NLR and T-PSA can increase the specificity of diagnose. There is a statistical difference in Gleason scores in patients with different NLR of prostate cancer (P=0.030). Conclusions It could increased the specificity when combined NLR and T-PSA to diagnose prostate cancer. And NLR has positive correlation with the prognosis of patients of prostate cancer as well.