外周血NLR、MLR、SⅡ在甲状腺髓样癌中的应用价值

Exploration of the application value of peripheral blood NLR,MLR and SⅡ in medullary thyroid carcinoma

目的:探讨外周血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)、系统免疫炎症指数(SⅡ)在甲状腺髓样癌(MTC)中的应用价值。方法:以我院2012年2月至2020年7月收治的MTC患者50例(MTC组)、甲状腺乳头状癌患者50例(PTC组)、健康体检者50例(健康对照组)为研究对象,比较三组患者外周血NLR、MLR、SⅡ水平的差异,并采用受试者工作特征曲线(ROC)分析上述三个指标及其联合检测在MTC中的诊断效能,进一步根据上述三个指标在诊断MTC中的最佳诊断界值分析其与MTC临床病理特征的相关性。结果:比较各组间外周血NLR、MLR、SⅡ水平示:MTC组NLR显著高于PTC组,差异有统计学意义(P<0.05);MTC组MLR、SⅡ水平显著高于PTC组与HC组,差异有统计学意义(P<0.05)。通过ROC曲线分析发现,NLR、MLR、SⅡ单独诊断MTC患者的ROC曲线下面积分别为0.620、0.681、0.634,NLR、MLR、SⅡ三者联合检测ROC曲线下面积为0.726。MLR单独检测及联合检测对MTC的诊断效能高于NLR、SⅡ单独检测(P<0.05)。MTC患者MLR与淋巴结转移及TNM分期有关,比较差异有统计学意义(P<0.05)。结论:NLR、MLR、SⅡ对MTC具有诊断价值,MLR单独检测及联合检测对MTC的诊断效能高于NLR、SⅡ单独检测。MLR与MTC患者淋巴结转移及TNM分期有关。

Objective:To explore the application value of peripheral blood neutrophil to lymphocyte ratio(NLR),monocyte to lymphocyte ratio(MLR)and systemicinflammatory index(SⅡ)in medullary thyroid carcinoma(MTC).Methods:The patients from our hospital in February 2012 to July 2020 were divided into, 50 cases of MTC patients group(MTC),50 patients with thyroid papillary carcinoma(PTC),50 cases of healthy physical examination as the research objects, and three groups of patients were compared with peripheral blood NLR,MLR,SⅡ level difference.Moreover, the receiver-operating characteristic curve(ROC)was adopted to analysis the diagnosis efficiency of the above three indicators and combination detection of them in MTC.Further, according to the above three indicators of the best diagnostic boundary value in MTC analysis its correlation with clinicopathological features of MTC.Results:The NLR of MTC group was significantly higher than that of PTC group, and the difference was statistically significant(P<0.05).MLR and SⅡ levels of MTC group were significantly higher than those of PTC group and HC groups, with statistically significant differences(P<0.05).According to the ROC curve analysis, the area under the ROC curve of NLR,MLR and SⅡ in the single diagnosis of MTC patients was 0.620,0.681 and 0.634,respectively.the area under ROC curve for combined detection of NLR,MLR and SⅡ is 0.726.The diagnostic efficacy of MLR alone and combined detection for MTC was higher than that of NLR and SⅡ alone(P<0.05).MLR in MTC patients was correlated with lymph node metastasis and TNM stage, and the difference was statistically significant(P<0.05).Conclusion:NLR,MLR and SⅡ have diagnostic value for MTC,and the diagnostic efficacy of MLR alone and combined detection for MTC was higher than that of NLR and SⅡ alone.MLR is associated with lymph node metastasis and TNM stage in MTC patients.