术前外周血标志物对子宫肉瘤的联合诊断价值分析

Diagnostic value of preoperative peripheral blood markers in uterine sarcomas

目的探讨术前糖链抗原125(CA125)、乳酸脱氢酶(LDH)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)与系统性免疫性炎症指数(SII)水平对子宫肉瘤诊断价值。方法回顾性分析2015年12月至2019年8月在中国科学技术大学附属第一医院经手术治疗的37例子宫肉瘤患者的临床资料(子宫肉瘤组),选取同期手术的74例子宫肌瘤患者作为子宫肌瘤组,统计分析所有患者术前一般资料,1周内外周血血常规、CA125、LDH结果,计算NLR、PLR、SII值,比较各指标数值在两组间的差异。以子宫肉瘤和子宫肌瘤作为应变量进行判别分析,选取肿瘤最大直径、LDH、CA125、NLR、PLR和SII等6个指标,采用Fisher准则建立判别函数并验证其效果。结果子宫肉瘤组外周血LDH、CA125、NLR、SII值水平均高于子宫肌瘤组,差异有统计学意义(P<0.05)。但子宫肉瘤组PLR水平均小于子宫肌瘤组,差异有统计学意义(P<0.05)。验证结果显示:使用以上6个临床指标针对子宫肌瘤的正确预测比例为83.2%,对于子宫肉瘤的正确判定率为67.4%。结论术前LDH、CA125、NLR、PLR和SII对子宫肉瘤的早期诊断及鉴别诊断具有临床实用价值。

Objective By analyzing the differences of carbohydrate antigen-125(CA125),lactic dehydrogenase(LDH),neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)and preoperative systemic immune-inflammation index(SII)between patients of uterine sarcoma to evaluate their diagnostic value.Methods A retrospective study was performed to analyze the clinical data of 37 patients with uterine sarcoma treated by surgery for the first time in the First Affiliated Hospital of USTC from January 2015 to August 2019.During the same period,74 patients with uterine fibroids who underwent concurrent surgery were selected as the uterine fibroids group.The peripheral blood routine test results,CA125 and LDH values of all patients within 1 week before surgery were statistically analyzed,and the values of NLR,PLR and SII were calculated.Uterine sarcoma and uterine fibroids were used as the dependent variables for discriminant analysis.Six indicators,including tumor maximum diameter,LDH,CA125,NLR,PLR and SII,were selected and Fisher's criterion was used to establish discriminant functions and verify the effect.Results LDH,CA125,NLR and SII in peripheral blood of uterine sarcoma group were significantly higher than those of the uterine fibroids group with statistical significance(P<0.05).However,PLR in uterine sarcoma group were both lower than that in hysteromyoma group with statistical significance(P<0.05).The results showed that the correct prediction rate for uterine fibroids using the above six clinical indicators was 83.2%,and the correct determination rate for uterine sarcomas was 67.4%.Conclusions The preoperative LDH,CA125,NLR,PLR and SII have clinical value in the early diagnosis and differential diagnosis of uterine sarcoma.