外周血中性粒细胞淋巴细胞比值、血小板淋巴细胞比值、CEA和AFP在原发性肝癌辅助诊断中的临床价值

Clinical value of the peripheral blood neutrophilic to lymphocyte ratio,platelet to lymphocyte ratio,CEA and AFP in the auxiliary diagnosis of primary liver cancer

目的:探讨中性粒细胞淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板淋巴细胞比值(platelet to lymphpcyte ratio,PLR)、癌胚抗原(carcinoembryonic antigen,CEA)和甲胎蛋白(alpha fetal protein,AFP)单独与联合检测在原发性肝癌辅助诊断中的临床应用价值。方法:对95例肝癌病人、90例肝硬化病人及同期100名健康体检者进行血常规、血清CEA和AFP检测,并利用ROC曲线分析NLR、PLR、CEA、AFP单独和联合检测对原发性肝癌的辅助诊断价值。结果:原发性肝癌组NLR、PRL、CEA和AFP水平均高于肝硬化组和对照组,肝硬化组NLR、PRL、CEA和AFP水平也高于对照组,差异均具有统计学意义(P<0.05~P<0.01)。NLR、PRL、CEA和AFP单独及联合用于原发性肝癌辅助诊断的ROC曲线下面积分别为0.827、0.602、0.816、0.942、0.983;灵敏度分别为81.2%、67.2%、78.6%、92.5%、96.7%;特异度分别为71.3%、64.5%、73.4%、82.3%、81.2%。NLR、PRL、CEA和AFP单独及联合用于原发性肝癌鉴别诊断的ROC曲线下面积分别为0.633、0.701、0.505、0.717、0.761;灵敏度分别为61.3%、68.7%、51.2%、70.6%、78.3%;特异度分别为68.4%、72.6%、56.7%、68.7%、73.2%。结论:NLR、PLR、CEA和AFP联合诊断试验可以提高原发性肝癌辅助诊断的灵敏度,对肝硬化的鉴别诊断也具有一定临床应用价值。

Objective:To explore the clinical value of single and combined detection of neutrophil to lymphocyte ratio(NLR),platelet to lymphpcyte ratio(PLR),carcinoembryonic antigen(CEA)and alpha fetal protein(AFP)in the early diagnosis of primary hepatocellular carcinoma(HCC).Methods:The routine blood,CEA and AFP in 95 patients with primary HCC,90 cases with liver cirrhosis and 100 healthy people in the same period were detected.The clinical value of single and combined detection of NLR,PLR,CEA and AFP in the auxiliary diagnosis of primary HCC were analyzed using the receiver operating characteristic(ROC)curve.Results:The levels of NLR,PLR,CEA and AFP in primary HCC group were higher than those in cirrhosis group and control group,and the levels of NLR,PLR,CEA and AFP in cirrhosis group were also higher than those in control group(P<0.05 to P<0.01).The areas under the ROC curve,sensitivities and specificities of the single and combined detection of NLR,PLR,CEA and AFP in the auxiliary diagnosis of primary liver cancer were(0.827,0.602,0.816,0.942 and 0.983),(81.2%,67.2%,78.6%,92.5%and 96.7%)and(71.3%,64.5%,73.4%,82.3%and 81.2%),respectively.The areas under the ROC curve,sensitivities and specificities of the single and combined detection of NLR,PLR,CEA and AFP in the differential diagnosis of primary liver cancer were(0.633,0.701,0.505,0.717 and 0.761),(61.3%,68.7%,51.2%,70.6%and 78.3%)and(68.4%,72.6%,56.7%,68.7%and 73.2%),respectively.Conclusions:The combined diagnostic tests of NLR,PLR,CEA and AFP can improve the sensitivity of auxiliary diagnosis of primary HCC,and have certain clinical application value in the differential diagnosis of liver cirrhosis.