摘要
目的探讨初诊为肺癌时的外周血淋巴细胞/单核细胞比值(lymphocyte/monocyte ratio,LMR)、中性粒细胞/淋巴细胞比值(neutrophil/lymphocyte ratio,NLR)与表皮生长因子受体(epidermal growth factor receptor,EGFR)突变阳性及其转移的相关性。方法回顾性分析301例、348例的肺癌EGFR突变阳性、阴性患者的基本临床特征及炎性指标。观察炎性指标在不同EGFR突变状态、转移状态的差异,用受试者工作特征(receiver operating characteristic,ROC)曲线评价其能否作为鉴别EGFR突变及转移的临床指标。结果在肺癌EGFR突变患者中女性、未吸烟、腺癌分别占61.8%、75.1%、92.4%。与阴性比较,EGFR突变阳性患者的LMR值明显升高,取界值为2.88时,其敏感度、特异性分别为64.7%、为56.6%。与未发生远处转移患者比较,NLR值在EGFR突变的远处转移患者中明显升高,当界值在2.14时,敏感度为74.7%,特异性为64.0%。NLR与EGFR突变阳性肺癌患者的TNM分期分别呈正相关,LMR则相反。NLR与EGFR突变阳性的肺癌患者的骨转移、脑转移、肿瘤指标如CEA、CA125之间存在显著相关性。结论肺癌EGFR突变常见于女性未吸烟腺癌特征,LMR、NLR在鉴别EGFR突变及远处转移具有参考价值。
Objective To investigate the diagnostic value of peripheral blood lymphocyte/monocyte ratio, neutrophil/lymphocyte ratio in identifying lung cancer EGFR mutation and metastasis. Methods The basic clinical features and inflammatory indexes of cancer patients with positive and negative EGFR mutations in 301 cases and 348 cases were retrospective analyzed. We observed the differences of EGFR mutations, metastatic status in different inflammatory indexes, and to evaluate whether they can be used as a clinical marker to identify EGFR mutations and metastases using the receiver operating characteristic curve. Results In patients with EGFR mutations, 61.8% was women, 75.1% was non-smoking, and 92.4% was adenocarcinoma. LMR was significantly higher in patients with EGFR mutations positive than in those of negative. When the LMR threshold was 2.88, the sensitivity and specificity were 64.7% and 56.6%, respectively. Compared with patients without distant metastases, NLR values were significantly higher in patients with distant metastases of EGFR mutation, with a sensitivity of 74.7% and a specificity of 64.0% at 2.14. There was a positive correlation between NLR and TNM staging of EGFR mutation-positive lung cancer patients, while LMR was the opposite. There was a significant correlation between NLR and EGFR mutation positive patient's bone metastasis, brain metastasis and tumor index, such as CEA and CA125. Conclusion EGFR mutation in lung cancer is common in women with non-smoking adenocarcinoma. LMR and NLR have some reference value in identifying EGFR mutation and distant metastasis.
作者
徐朝娜
任瑛瑛
黄晓颖
王良兴
Xu Zhaona;Ren Yingying;Huang Xiaoying(Department of Respiratory Medicine,The First Affiliated Hospital of Wenzhou Medical University,Wenzhou Key Laboratory of Respiratory Cycle,Zhejiang 325000,Chin)
出处
《医学研究杂志》
2018年第7期120-125,共6页
Journal of Medical Research