NLR、FAR、SCC-Ag对宫颈鳞状细胞癌患者术前淋巴结转移的预测价值

Predictive value of NLR, FAR and SCC-Ag in preoperative lymph node metastasis of patients with cervical squamous cell carcinoma

目的 研究中性粒细胞/淋巴细胞比值(NLR)、纤维蛋白原/白蛋白比值(FAR)、鳞状细胞癌抗原(SCC-Ag)对宫颈鳞状细胞癌患者术前淋巴结转移的预测价值。方法 选取2013年6月至2016年12月在浙江大学医学院附属妇产科医院收治的213例宫颈鳞状细胞癌患者,淋巴结阳性61例,分为转移组,淋巴结阴性152例,分为未转移组。检测患者组织病理、SCC-Ag、中性粒细胞、淋巴细胞、纤维蛋白原、白蛋白水平,计算NLR、FAR。结果 转移组Ⅱ期临床分期、SCC-Ag、淋巴细胞数、白蛋白高于未转移组Ⅱ期(P <0.05)。转移组的NLR、FAR、SCC-Ag均高于未移组(P <0.05)。Logistic回归模型分析NLR、FAR、SCC-Ag是宫颈鳞状细胞癌患者术前淋巴结转移的危险因素。受试者工作特征曲线(ROC)分析NLR、FAR、SCC-Ag及联合检测均可预测宫颈鳞状细胞癌患者术前淋巴结转移,联合检测曲线下面积(AUC)最大。结论 宫颈鳞状细胞癌淋巴结转移患者术前NLR、FAR、SCC-Ag升高,是宫颈鳞状细胞癌患者术前淋巴结转移的危险因素,NLR、FAR、SCC-Ag及联合检测均可预测宫颈鳞状细胞癌患者术前淋巴结转移,联合检测预测宫颈鳞状细胞癌患者术前淋巴结转移效能最高。

Objective To investigate the predictive value of neutrophil/lymphocyte ratio(NLR), fibrinogen/albumin ratio(FAR) and squamous cell carcinoma antigen(SCC-Ag) for preoperative lymph node metastasis in patients with cervical squamous cell carcinoma. Methods A total of 213 patients with cervical squamous cell carcinoma admitted to the Affiliated Obstetrics and Gynecology Hospital, College of Medicine, Zhejiang University from June 2013 to December 2016 were collected into our study and were divided into the metastatic group(61 patients) and non-metastatic group(152 cases). The histopathology, the serum level of SCC-Ag, neutrophil, lymphocyte, fibrinogen,albumin were determined and the NLR and FAR were calculated. Results Compared with the non-metastatic group,the stage Ⅱ clinical stage, SCC-Ag, lymphocyte count and albumin in the metastatic group were higher(P < 0.05).The Logistic regression model showed that NLR, FAR and SCC-Ag were risk factors for preoperative lymph node metastasis in patients with cervical squamous cell carcinoma(P < 0.05). The receiver operating characteristic curve(ROC) showed that NLR, FAR, SCC-Ag and NLR + FAR + SCC-Ag could be used to predict cervical squamous cell carcinoma lymph node metastasis, and the area under the curve(AUC) of NLR + FAR + SCC-Ag was the largest.Conclusions Preoperative NLR, FAR and SCC-Ag increased in patients with cervical squamous cell carcinoma lymph node metastasis, and could be used as the risk predictors. NLR, FAR, SCC-Ag and NLR + FAR + SCC-Ag can predict preoperative lymph node metastasis in patients with cervical squamous cell carcinoma, and NLR + FAR + SCCAg has the highest effect value.