NLR、PLR、RDW检测在结直肠癌诊断、预后评估中的研究

Application of NLR,PLR and RDW detection in diagnosis and prognosis evaluation of colorectal cancer

目的分析中性粒细胞计数与淋巴细胞计数比值(NLR)、血小板计数与淋巴细胞计数比值(PLR)及红细胞分布宽度(RDW)检测在结直肠癌诊断、预后评估中的应用。方法收集本院2012年1月至2014年12月收治的120例结直肠癌患者设为结直肠癌组;另外收集行肠镜活检确诊为结直肠癌相关癌前病变者将其分为结直肠息肉组(n=25)例、炎症性肠病组(n=28)例;同时选取同期体检的132例正常者为正常对照组。比较NLR、PLR及RDW在各组间表达情况,计算不同检查对结直肠癌患者的诊断价值。记录结直肠癌患者在随访时间内预后生存情况,采用多元Logistic回归分析影响结直肠癌患者预后生存的危险因素。结果结直肠癌组NLR、PLR及RDW水平明显高于结直肠息肉组、炎症性肠病组及正常对照组,差异有统计学意义(P<0.05)。结直肠息肉组NLR、PLR及RDW水平与炎症性肠病组比较差异无统计学意义(P>0.05)。NLR、PLR及RDW三者联合(串联)的敏感性、准确性均高于任何指标单一检测,差异有统计学意义(P<0.05)。Logistic回归模型分析显示:组织分型为低分化、TNM分期处于Ⅲ、Ⅳ期、有淋巴结转移、NLR、PLR及RDW水平异常升高表达为影响结直肠癌患者预后生存的危险因素(P<0.05)。结论 NLR、PLR及RDW检测结直肠癌具有一定诊断价值,其水平变化与患者预后具有一定相关性,临床工作者加强对其指标检测,具有一定借鉴作用。

Objective To analyze the application of preoperative neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR)and red blood cell distribution width(RDW)detection in the diagnosis and prognosis evaluation of colorectal cancer. Method The 120 patients with colorectal cancer admitted to this hospital from January 2012 to December 2014 were collected as the colorectal cancer group. In addition,the patients who were diagnosed with colorectal cancer-related precancerous lesions by colonoscope biopsy were divided into the colorectal polyp group(n=25),and the inflammatory bowel disease group(n=28).At the same time,132 normal patients who received physical examination during the same period were selected as the normal control group. The expressions of NLR,PLR and RDW in each group were compared,and the values of different examinations in the diagnosis of colorectal cancer in patients were calculated. The prognostic survival of patients with colorectal cancer during the follow-up period was recorded,and multivariate logistic regression was used to analyze the risk factors that affect the prognosis survival of patients with colorectal cancer. Results The levels of NLR,PLR and RDW in the colorectal cancer group were significantly higher than those in the colorectal polyp group,the inflammatory bowel disease group,and the normal control group. The differences were statistically significant(P<0.05). There were no significant differences in the NLR,PLR and RDW levels between the colorectal polyp group and the inflammatory bowel disease group(P>0.05). The sensitivity and accuracy of the combined detection of NLR,PLR and RDW levels(in series)were higher than those of any single detection,and the difference was statistically significant(P<0.05). Logistic regression model analysis showed that poorly differentiated tissue classification,TNM staging in Ⅲ and Ⅳ,lymph node metastasis,abnormal elevated levels of NLR,PLR and RDW are risk factors affecting the prognosis survival of patients with colorectal cancer(P<0.05). Conclusion The detection of NLR,PLR and RDW in colorectal cancer patients has a certain diagnostic value,and the level change in its level has a certain correlation with the patient’s prognosis.Clinicians should strengthen the detection of those indicators,which can be used for reference.