术前NLR、CA125及血浆D-二聚体在子宫内膜癌诊断中的临床价值

The Clinical Value of Preoperative NLR,CA125 and Plasma D-dimer in the Diagnosis of Endometrial Carcinoma

目的探讨子宫内膜癌患者术前中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、糖类抗原125(carbohydrate antigen 125,CA125)、血浆D-二聚体的表达水平及上述指标联合检测在子宫内膜癌诊断中的临床价值。方法回顾性分析我科2017年3月—2020年3月经手术治疗并有明确病理诊断的83例子宫内膜息肉患者(子宫内膜良性肿瘤组)和71例子宫内膜癌患者(子宫内膜恶性肿瘤组)的临床资料。比较分析血清中性粒细胞计数(neutrophil count,NEU)、淋巴细胞计数(lymphocyte count,LYM)、CA125及血浆D-二聚体水平,并进一步计算NLR值(NLR=NEU/LYM)。运用ROC曲线对NLR、CA125、血浆D-二聚体进行分析。结果子宫内膜恶性肿瘤组NLR、CA125、血浆D-二聚体表达水平均显著高于子宫内膜良性肿瘤组(P<0.01);中晚期组CA125的表达水平显著高于早期组(P<0.01);三项联合检测的曲线下面积最大(0.787),NLR、CA125、血浆D-二聚体单项检测的诊断效能低于三项联合检测。结论子宫内膜癌患者NLR、CA125及血浆D-二聚体水平均呈高表达,三项联合检测对子宫内膜癌的早期诊断具有重要的临床价值。

Objective To investigate the expression levels of neutrophil to lymphocyte ratio(NLR),carbohydrate antigen 125(CA125)and plasma D-dimer before operation in patients with endometrial cancer and the clinical value of the combined detection of these indicators in the diagnosis of endometrial cancer.Methods The clinical data of 83 cases of endometrial polyps(benign endometrial tumor group)and 71 cases of endometrial carcinoma(malignant endometrial tumor group)treated by surgery and confirmed pathological diagnosis in our department from March 2017 to March 2020 were retrospectively analyzed.Serum neutrophil count(NEU),lymphocyte count(LYM),CA125 and plasma D-dimer levels were compared,and NLR value(NLR=NEU/LYM)was further calculated.NLR,CA125 and plasma D-dimer were analyzed by ROC curve.Results The expression levels of NLR,CA125 and plasma D-dimer in malignant endometrial tumor group were significantly higher than those in benign endometrial tumor group(P<0.01).The expression level of CA125 in middle and late group was significantly higher than that in early group(P<0.01).The area under the curve of the three combined tests was the largest(0.787),and the diagnostic efficiency of the single detection of NLR,CA125 and plasma D-dimer was lower than that of the three combined tests.Conclusion The levels of NLR,CA125 and plasma D-dimer were all highly expressed in endometrial cancer patients,and the three combined detection methods have important clinical value for the early diagnosis of endometrial cancer.