中性粒细胞与淋巴细胞比值和癌胚抗原在鉴别良恶性胸腔积液中的应用价值

Application Value of Neutrophil-to-Lymphocyte Ratio and Carcino-Embryonic Antigen in Differentiating Benign and Malignant Pleural Effusion

目的探讨外周血中性粒细胞与淋巴细胞比值(NLR)和胸腔积液癌胚抗原(CEA)在鉴别良恶性胸腔积液中的应用价值。方法回顾性分析2019年6月至2020年6月于郑州大学第一附属医院就诊的230例胸腔积液患者的临床资料,根据胸腔积液性质分为恶性组(110例)和良性组(120例)。比较两组中性粒细胞计数、淋巴细胞计数、NLR和胸腔积液CEA水平。以病理学检查结果为金标准,利用受试者工作特征(ROC)曲线评估NLR、胸水CEA水平及两者联合检测的诊断效能。结果恶性组患者中性粒细胞计数、NLR、胸水CEA水平高于良性组,淋巴细胞计数低于良性组,差异有统计学意义(P<0.05)。ROC曲线显示,NLR、胸水CEA、联合检测的ROC曲线下面积(AUC)分别为0.740、0.871、0.906。NLR灵敏度为70.00%,特异度为70.83%;胸水CEA灵敏度为77.27%,特异度为89.17%;两者联合检测的灵敏度和特异度分别为79.09%、94.17%。结论外周血NLR和胸腔积液CEA水平可以作为鉴别良恶性胸腔积液的指标,且两者联合检测诊断效能更高。

Objective To explore the value of peripheral blood neutrophil-to-lymphocyte ratio(NLR)and pleural effusion carcino-embryonic antigen(CEA)in the identification of benign and malignant pleural effusions.Methods The clinical data of 230 patients with pleural effusion who were treated in the First Affiliated Hospital of Zhengzhou University from June 2019 to June 2020 were retrospectively analyzed.According to the nature of pleural effusion,the patients were divided into malignant group(110 cases)and benign group(120 cases).The neutrophil count,lymphocyte count,NLR and pleural effusion CEA levels were compared between the two groups.Using pathological examination results as the gold standard,the receiver operating characteristic(ROC)curve was used to evaluate the diagnostic efficacy of NLR,pleural fluid CEA level and the combined detection of the two.Results The neutrophil count,NLR,and pleural fluid CEA level in malignant group were higher than those in benign group(P<0.05),and the lymphocyte count in malignant group was lower than that in benign group(P<0.05).The ROC curve showed that the area under the curve(AUC)of NLR,pleural fluid CEA,and the combined detection were 0.740,0.871,and 0.906,respectively.The sensitivity of NLR was 70.00%,and the specificity was 70.83%.The sensitivity of pleural effusion CEA was 77.27%,and the specificity was 89.17%.The sensitivity and specificity of the combined detection of the two were 79.09%and 94.17%,respectively.Conclusion Peripheral blood NLR and pleural effusion CEA levels could be used as indicators to distinguish benign and malignant pleural effusions,and the combined detection of the two has a higher diagnostic efficiency.