中性粒细胞与淋巴细胞比值联合癌胚抗原对结直肠癌早期诊断的研究

Early Diagnosis of Colorectal Cancer by Neutrophil-lymphocyte Ratio Combined with Carcinoembryonic Antigen

目的探讨应用外周血中性粒细胞与淋巴细胞比值(NLR)联合癌胚抗原(CEA)对结直肠癌早期诊断的意义。方法选取2016年1月～2018年1月来我院初治的结直肠癌患者103例为研究组,选取同期我院147例结直肠腺瘤性息肉患者为息肉组,体检中心150例健康体检者为对照组。通过受试者工作特征曲线(ROC曲线)测定NLR诊断结直肠癌的临界值,并与CEA联合诊断判断NLR联合CEA对提高结直肠癌的诊断的特异度及敏感度是否有优势。结果研究组中性粒细胞、NLR和CEA的表达量高于息肉组和对照组(P<0.05);对照组淋巴细胞的表达量高于研究组和息肉组,息肉组淋巴细胞的表达量高于研究组(P均<0.05);息肉组NLR和CEA的表达量均高于对照组(P<0.05)。通过ROC曲线测定NLR诊断结直肠癌的最佳截点值1.760,敏感度83.13%,特异度62.00%,AUC为0.80,95%CI为0.75～0.86。NLR联合CEA诊断结直肠癌的敏感度75.90%,特异度93.35%,AUC为0.89,95%CI为0.84～0.94。结论应用NLR对结直肠癌的诊断有较高的敏感性与特异性,所以当NLR联合CEA诊断的时候,结直肠癌早期的敏感性和特异性会有所提高。

Objective To investigate the significance of peripheral blood neutrophil-to-lymphocyte ratio(NLR)combined with carcinoembryonic antigen(CEA)in the early diagnosis of colorectal cancer.Methods A total of 103 patients with colorectal cancer who were admitted to our hospital from January 2016 to January 2018 were enrolled in the study group.A total of 147 patients with colorectal adenomatous polyps in the same period were enrolled in the polyp group,and 150 physical examinations in the physical examination center.The control group.NLR was used to determine the critical value of colorectal cancer by receiver operating characteristic curve(ROC curve),and combined with CEA to determine whether NLR combined with CEA has an advantage in improving the specificity and sensitivity of colorectal cancer diagnosis.Results The expression of neutrophil,NLR and CEA in study group was higher than that in polyp group and control group(P<0.05).The expression of lymphocytes in the control group was higher than that in the study group and polyp group,and the expression of NLR and CEA in the polyp group was higher than that in the control group(P<0.05),and the expression of NLR and CEA in the polyp group was higher than that in the control group(P<0.05).The best cut-off value of NLR for the diagnosis of colorectal cancer by ROC curve was 1.760,the sensitivity was 83.13%,the specificity was 62.00%and the AUC was 0.80,95%CI is 0.75~0.86.The sensitivity of NLR combined with CEA in the diagnosis of colorectal cancer was 75.90%,the specificity was 93.35%,the AUC was 0.89,and the 95%CI was 0.84~0.94.Conclusion The application of NLR has a high sensitivity and specificity for the diagnosis of colorectal cancer.Therefore,when NLR is combined with CEA diagnosis,the sensitivity and specificity of early colorectal cancer will be improved.