外周血炎症相关指标联合癌胚抗原对结直肠癌的诊断价值

Diagnostic value of peripheral blood inflammation related indicators combined with carcinoembryonic antigen in colorectal cancer

目的探讨外周血炎症相关指标血小板与淋巴细胞比值(PLR)、中性粒细胞与淋巴细胞比值(NLR)、单核细胞与淋巴细胞比值(MLR)联合癌胚抗原(CEA)对结直肠癌的诊断价值,以及与结直肠癌临床病理特征的关系,为结直肠癌的早期诊断和预后判断提供一定的参考。方法选择2019年1月至2020年6月来该院治疗的170例结直肠癌患者作为结直肠癌组,并以80例结直肠息肉病患者作为结直肠息肉组以及80例体检健康者作为健康组,行血常规和CEA检测。比较3组之间、不同病理和临床分期的结直肠癌患者之间PLR、NLR、MLR及CEA的差异,并对PLR、NLR、MLR及CEA之间的相关性,其单独检测及联合检测对结直肠癌诊断价值进行分析。结果与健康组和结直肠息肉组相比,结直肠癌组的PLR、NLR、MLR及CEA均明显升高(P<0.05)。对于不同病理分期的结直肠癌患者,N2组的PLR和CEA相较于N0组明显升高,N1组的PLR相较于N0组明显升高(P<0.05)。M1组较M0组PLR、NLR和CEA均明显升高(P<0.05)。对于不同临床分期的结直肠癌患者,Ⅲ期患者的PLR和CEA相比于Ⅰ期明显升高,Ⅳ期患者的PLR和CEA相比于Ⅰ期明显升高且NLR相比于Ⅰ期和Ⅱ期均明显升高,以上差异均有统计学意义(P<0.05)。对炎症相关指标及CEA的相关性分析发现,PLR、NLR、MLR三者任意二者之间均具有相关关系,PLR与CEA也存在相关关系。PLR、NLR及CEA三者联合检测时,相比于单一检测或者其他任意组合对结直肠癌的诊断效能更高,受试者工作特征(ROC)曲线下面积(AUC)为0.729。结论外周血炎症相关指标及CEA在结直肠癌组中明显升高,且与病理及临床分期密切相关。炎症相关指标及CEA之间存在一定相关性,联合诊断对于提高结直肠癌检出率具有一定的临床意义。

Objective To explore the diagnostic value of peripheral blood inflammation-related indicators platelet-lymphocyte ratio(PLR),neutrophil-lymphocyte ratio(NLR),monocyte-lymphocyte ratio(MLR)combined with carcinoembryonic antigen(CEA)for colorectal cancer,and the relationship between these indicators and pathological features of colorectal cancer,so as to provide a certain reference value for the early diagnosis and prognosis judgment of colorectal cancer.Methods One hundred and seventy colorectal cancer patients who came to the hospital for treatment from January 2019 to June 2020 were designated as colorectal cancer group,80 colorectal polyposis patients and 80 healthy people were designated as controls.Routine blood testing and CEA testing were performed for them.Then the PLR,NLR,MLR and CEA among three groups and in colorectal cancer patients with different pathological and clinical stages.Explore the correlation between PLR,NLR,MLR and CEA,and their diagnostic value in colorectal cancer.Results Compared with healthy people and colorectal polyps patients,the PLR,NLR,MLR and CEA in colorectal cancer patients significantly increased(P<0.05).For colorectal cancer patients with different pathological stages,the PLR and CEA in the N2 group were significantly higher than those in the N0 group,and the PLR in the N1 group was significantly higher than that in the N0 group(P<0.05).Compared with M0 group,PLR,NLR and CEA were significantly higher in M1 group.For colorectal cancer patients of different clinical stages,the PLR and CEA in stageⅢpatients were significantly higher than those in stageⅠpatients.The PLR and CEA in stageⅣpatients were significantly higher than those in stageⅠpatients.The NLR in stageⅣpatients was significantly higher than that in stageⅠand stageⅡpatients.The above differences were statistically significant(P<0.05).The PLR,NLR,and MLR were all correlated,and there was also a correlation between PLR and CEA.When PLR,NLR and CEA were combined,the diagnostic efficiency for colorectal cancer was higher than a single test or any other combination,and the area under the ROC curve(AUC)was 0.729.Conclusion Peripheral blood inflammation-related indicators and CEA are significantly elevated in patients with colorectal cancer,and are closely related to pathological and clinical stages.There are some correlations between inflammation related indicators and CEA.Combined detection has clinical significance for improving the early diagnosis rate of colorectal cancer.