外周血NLR、HCT、SCC、CA125在宫颈癌诊疗中的应用

The application of detection of peripheral blood NLR,HCT,SCC and CA125 in the diagnosis and treatment of cervical cancer

目的探讨外周血中性粒细胞与淋巴细胞比值(NLR)、血细胞比容(HCT)、鳞状上皮细胞癌抗原(SCC)、糖类抗原125(CA125)联合检测在宫颈癌辅助诊断和放、化疗中的应用价值。方法比较291例宫颈癌初诊患者和200例健康女性体检者NLR、HCT、SCC、CA125水平,分析单一指标及各指标联合对宫颈癌的诊断价值及与病理类型、分期之间的关系。观察HCT、SCC、CA125联合检测对人乳头瘤病毒阴性宫颈癌患者的诊断效能。分析40例宫颈癌患者放、化疗前后SCC、CA125的差异。结果宫颈癌组较对照组的NLR、SCC、CA125水平升高、HCT水平降低(P<0.05);受试者工作特征曲线分析显示联合检测HCT、SCC、CA125诊断宫颈癌的曲线下面积、灵敏度、特异度分别为95.26%、89.06%、92.63%;宫颈癌Ⅲ~Ⅳ期患者较Ⅰ~Ⅱ期患者的NLR、SCC、CA125水平升高,HCT水平降低(P<0.05)。联合检测HCT、SCC、CA125对HPV阴性宫颈癌患者诊断的灵敏度为40.00%。宫颈癌患者放化疗后SCC、CA125水平降低(P<0.05)。结论HCT、SCC、CA125联合检测可提高宫颈癌诊断的灵敏度,有助于宫颈癌的早期诊断、临床分期及病理类型的鉴别;SCC、CA125可作为宫颈癌放、化疗疗效评估的指标。

Objective To investigate the value of combined detection of peripheral blood neutrophil to lymphocyte ratio(NLR),hematocrit(HCT),squamous cell carcinoma antigen(SCC),carbohydrate antigen 125(CA125)in adjuvant diagnosis and radiotherapy and chemotherapy of cervical cancer.Methods The levels of NLR,HCT,SCC,and CA125 in 291 patients who were preliminarily diagnosed cervical cancer and 200 healthy people were compared,and analyze of the diagnostic value of single indicators and combined indicators for cervical cancer and its relationship with pathological type and stage.Observe the diagnostic efficacy of combine HCT,SCC and CA125 to diagnose human popillomavirus negative cervical cancer patients.Compare the differences between the the detection results of SCC and CA125 in 40 patients with cervical cancer which have radiotherapy and chemotherapy treatment.Results The levels of NLR,SCC and CA125 in cervical cancer group were higher,and lower levels of HCT than those in healthy people group(P<0.05);the receiver operating characteristic analysis showed that the area under curve,sensitivity and specificity of combined HCT,SCC and CA125 were 95.26%,89.06%,and 92.63%;The patients who have cervical cancer stageⅢ-Ⅳhad higher levels of NLR,SCC,and CA125,and lower levels of HCT than the patients who have cervical cancer stageⅠ-Ⅱ(P<0.05).Combine HCT,SCC and CA125 to diagnose HPV negative cervical cancer patients sensitivity was 40.00%.The levels of SCC and CA125 in cervical cancer patients after radiotherapy and chemotherapy lower(P<0.05).Conclusion The combined detection of HCT,SCC,and CA125 can effectively improve the sensitivity of cervical cancer diagnosis and contribute to the early diagnosis of cervical cancer,auxiliary in staging and identification of pathological types;SCC and CA125 can be used as indicators for evaluating the therapeutic effect of radiotherapy and chemotherapy of cervical cancer.