外周血NLR、PLR、MLR和CEA对胃癌的诊断价值

Value of NLR,PLR,MLR and CEA in peripheral blood in the diagnosis of gastric cancer

目的探讨外周血中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、单核细胞/淋巴细胞比值(MLR)和癌胚抗原(CEA)单独或联合检测对胃癌的诊断价值。方法检测行胃癌根治术的胃癌患者457例(A组)、胃良性疾病患者430例(B组)和胃肠镜检查未见明显异常的健康体检者457例(C组)的外周血NLR、PLR、MLR和CEA。分析A组术前NLR、PLR和MLR与术后临床病理特征的关系,绘制ROC曲线评估NLR、PLR、MLR、CEA单独或联合检测对胃癌的诊断效能。结果A组术前NLR、PLR、MLR和CEA高于B组和C组(P<0.05)。A组术前NLR、PLR和MLR在肿瘤直径、浸润深度、淋巴结转移、远处转移和临床分期组间比较均有统计学差异(P<0.01)。单项检测时,PLR曲线下面积均大于NLR、MLR和CEA(0.76 vs.0.67、0.62和0.59)(P<0.05)。NLR、PLR、MLR和CEA单项检测诊断胃癌的灵敏度为70.50%、70.90%、54.30%和27.80%,特异度为56.20%、69.80%、65.60%和96.30%。联合检测时,PLR+CEA曲线下面积均大于NLR+CEA和MLR+CEA(0.78 vs.0.69和0.68)(P<0.05)。NLR+CEA、PLR+CEA和MLR+CEA诊断胃癌的灵敏度为65.60%、71.16%和58.90%,特异度为63.10%、71.40%和69.30%。结论术前外周血NLR、PLR、MLR和CEA检测对胃癌具有诊断价值,联合检测可提高其诊断效能,尤其是术前外周血PLR单独或联合CEA检测。

Objective To investigate the value of the ratio of neutrophil to lymphocyte(NLR),platelet to lymphocyte(PLR) or ratio of monocyte to lymphocyte(MLR) and carcinoembryonic antigen(CEA) alone or in combination in peripheral blood for the diagnosis of gastric cancer.MethodsThe NLR,PLR,MLR and CEA in peripheral blood were detected in 457 patients with gastric cancer(group A),430 patients with gastric benign disease(group B) and 457 healthy people underwent gastroenteroscopy with no obvious abnormality(group C).The relationship between preoperative NLR,PLR,MLR and postoperative clinicopathological features were analyzed in group A.ROC curve was drawn to analyze the diagnostic efficacy of NLR,PLR,MLR and CEA alone or in combination for gastric cancer.Results The preoperative NLR,PLR,MLR and CEA level in group A were higher than those in groups of B and C(P<0.05).There were significant differences of preoperative NLR,PLR and MLR in tumor diameter, invasion depth, lymph node metastasis, distant metastasis and clinical stage in group A(P<0.01).The area under the curve of PLR was larger than that of NLR,MLR or CEA(0.76 vs.0.67,0.62 or 0.59)(P<0.05).The sensitivities of NLR,PLR,MLR and CEA for the diagnosis of gastric cancer were 70.50%,70.90%,54.30% and 27.80%,and the specificities were 56.20%,69.80%,65.60% and 96.30%,respectively.The area under the curve of PLR plus CEA was larger than that of NLR plus CEA and MLR plus CEA(0.78 vs.0.69 and 0.68)(P<0.05).The sensitivities of NLR plus CEA,PLR plus CEA and MLR plus CEA were 65.60%,71.16% and 58.90%,and the specificities were 63.10%,71.40% and 69.30%,respectively.Conclusion Preoperative NLR,PLR,MLR and CEA have diagnostic value in gastric cancer, and combined detection of them can improve the diagnostic efficiency, especially PLR in peripheral blood alone or combined with CEA.