膀胱癌患者外周血中性粒细胞与淋巴细胞比值及红细胞分布宽度的变化及临床意义

Changes of ratio of peripheral blood neutrophil to lymphocyte ratio and red blood cell distribution width in the bladder cancer and their clinical significance

目的研究膀胱癌外周血中性粒细胞与淋巴细胞比值(NLR)及红细胞分布宽度(RDW)的变化及临床意义。方法收集2013年4月至2015年4月山东大学附属省立医院住院膀胱癌确诊患者243例为膀胱癌组,选取同期体检健康志愿者99例为健康对照组。比较两组NLR、RDW水平差异及与其他病理参数的关系。结果膀胱癌组NLR和RDW高于健康对照组[2.24(1.61,3,17)vs 1.46(1.15,2.04)、13(12.52,13.6)vs 12.8(12.6,13)],差异均有统计学意义(P<0.05)。绘制ROC曲线,NLR曲线下面积为0.753,确定最佳截点后,将243例膀胱癌患者分为低NLR(≤2.32,125例)组和高NLR(>2.32,118例)组,高NLR组尿红细胞(RBC)、尿白细胞(WBC)水平显著高于低NLR组[18 925.8(483.4,18 925.8)vs 5.2(5.2,32.5)、18(18,197)vs 20.7(15.2,20.7)],差异均有统计学意义(P<0.05)。RDW曲线下面积为0.771,根据RDW水平的不同分为低RDW(≤12.75,87例)组和高RDW(>12.75,156例)组,高NLR组与低NLR组患者在肿瘤分级中差异有统计学意义(P<0.05)。高NLR组与低NLR组患者在肿瘤临床分期中差异有统计学意义(P<0.05),高RDW组与低RDW组在尿RBC、尿WBC、尿上皮细胞(EC)及患者的肿瘤分期、分级中均无统计学意义(P>0.05)。结论膀胱癌患者NLR和RDW水平显著升高,为区分癌症和正常人提供了重要的参考价值,此外NLR还可作为膀胱癌患者病情评估的指标。

Objective To study the changes of ratio of peripheral blood（PB） neutrophil to lymphocyte ratio（NLR） and red blood cell distribution width（RDW） in the bladder cancer and their clinical significance. Methods A total of 243 cases of patients with bladder cancer, who admitted to Shandong Provincial Hospital Affiliated to Shandong University from April 2013 to April 2015, were selected as the bladder cancer group. Meantime, 99 healthy volunteers were chosen as the control group. The differences of PB-NLR and RDW levels of the two groups were compared and their relationships with other pathological parameters were analyzed. Results PB-NLR and RDW in the bladder cancer group were 2.24（1.61, 3, 2） and 13（12.52, 13.6）, which were significantly higher than 1.46（1.15, 1.15） and 12.8（12.6,13） in the control group（P〈0.05）. Depending on the level of NLR, ROC curve was analyzed to determine the best cutoff point in bladder cancer patients, and PB-NLR area under the curve was 0.753. Urinary red blood cell（RBC） and urine white blood cell（WBC） level in the high PB-NLR group（2.32, 118 cases） were 18 925.8（483.4, 18 925.8） and 18（18,197）, which were significantly higher than 5.2（5.2, 32.5） and 20.7（15.2, 20.7） in the low PB-NLR group（≤2.32, 125 cases）（all P〈0.05）. There was no significant difference between the high RDW group and the low RDW group in urinary RBC, urine WBC, Unrinary epithelial cell（EC） and the tumor classification and stages（P〈0.05）. Conclusion PB-NLR and RDW are significantly elevated in patients with bladder cancer, which provide an important reference value for distinguishing patients with bladder cancer from normal human. In addition, NLR can be used an indicator for the assessment of patients with bladder cancer.