外周血RDW和NLR联合检测对食管癌的诊断价值研究

The value of combined detection of RDW and NLR in serum in the diagnosis of esophageal cancer

目的 探讨食管癌患者外周血中红细胞分布宽度(RDW)和中性粒细胞与淋巴细胞比值(NLR)联合检测在食管癌诊断中的价值。方法选取2019年6月至2021年6月于徐州医科大学附属医院消化科就诊的患者497例,其中食管癌组225例,健康对照组272例,以上均有病理结果证实。比较两组血清RDW、NLR、癌胚抗原(CEA)、糖类抗原199(CA199)的表达水平及阳性检出率,采用ROC曲线分析各指标单独及联合检测对食管癌的诊断效能。结果食管癌组血清RDW、NLR、CEA、CA199水平及阳性检出率均高于健康对照组(P<0.05)。通过ROC分析,RDW、NLR曲线下面积分别为0.884、0.868,均明显高于CEA、CA199(P<0.05),RDW联合NLR曲线下面积为0.954,明显高于CEA联合CA199(P<0.05)。结论食管癌患者血清中RDW、NLR水平较健康人群增高,二者联合检测可作为食管癌早期辅助诊断的血清标志物,具有重要的临床意义和价值。

Objective To explore the value of combined detection of red blood cell distribution width(RDW)and neutrophil lymphocyte ratio(NLR)in the diagnosis of esophageal cancer.Methods a total of 497 patients were selected from the Department of Gastroenterology of the Affiliated Hospital of Xuzhou Medical University from June 2019 to June 2021,including 225 cases in the esophageal cancer group and 272 cases in the normal control group.The above were confirmed by pathological results.The expression levels and positive detection rates of serum RDW,NLR,carcinoembryonic antigen(CEA)and carbohydrate antigen 199(CA199)were compared between the two groups.ROC curve was used to analyze the diagnostic efficacy of individual and combined detection of each index in esophageal cancer.Results The levels and positive detection rates of serum RDW,NLR,CEA and CA199 in esophageal cancer group were significantly higher than those in normal control group(P<0.05).Through ROC analysis,the area under RDW and NLR curves were 0.884 and 0.868 respectively,which were significantly higher than CEA and CA199.The difference was statistically significant by Z Test(P<0.05).The area under RDW combined with NLR curve was 0.954,which was significantly higher than CEA combined with CA199.The difference was statistically significant by Z Test(P<0.05).Conclusion The serum levels of RDW and NLR in patients with esophageal cancer are higher than those in normal population.The combined detection of RDW and NLR can be used as serum markers for early auxiliary diagnosis of esophageal cancer,which has important clinical value.