不同类型的肺部磨玻璃结节患者术前免疫炎症指标和癌胚抗原的比较

Comparison of preoperative immune-inflammation index and carcinoembryonic antigen in different pathological types of ground-glass opacity

目的:比较不同病理类型的肺部磨玻璃结节(GGO)患者术前中性粒细胞与淋巴细胞比率(NLR)、血小板与淋巴细胞比率(PLR)、淋巴细胞与单核细胞比率(LMR)和血清癌胚抗原(CEA)的差异及其临床意义。方法:收集接受手术治疗的494例患者的NLR、PLR、LMR,其中浸润性腺癌176例,微浸润性腺癌150例,腺体前驱病变117例,良性病变51例。仅收集到150例浸润性腺癌、127例微浸润性腺癌、95例腺体前驱病变和45例良性病变的血清CEA数值。分别比较各组之间的NLR、PLR、LMR、CEA。结果:腺体前驱病变组的NLR(2.32±1.59)较良性病变组(1.82±0.64)高(P<0.05)。肺腺癌组的PLR(141.19±53.14)、腺体前驱病变组的PLR(145.94±51.92)较良性病变组(124.90±37.04)高(均P<0.05)。肺腺癌组的CEA[1.83(1.18,2.73)ng/mL]较腺体前驱病变+良性病变组[1.49(1.03,2.08)ng/mL]高(P<0.01)。浸润性腺癌组的CEA[2.14(1.29,2.92)ng/mL]分别较微浸润性腺癌组[1.67(1.09,2.43)ng/mL]、腺体前驱病变组[1.46(1.03,2.06)ng/mL]、良性病变组[1.53(1.00,2.10)ng/mL]高(P<0.05)。结论:全身免疫炎症指标在早期肺腺癌,甚至是腺体前驱病变阶段就开始发生变化,血清CEA在早期肺腺癌就开始发生变化。动态观察上述指标的变化,有利于早期发现恶性病变,从而尽早进行干预。

Objective:To compare the preoperative neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),lymphocyte to monocyte ratio(LMR)and serum carcinoembryonic antigen(CEA)in different pathological types of ground-glass opacity(GGO)in order to explore whether there were differences and their significance.Methods:The NLR,PLR and LMR of 494 GGO patients who underwent surgical treatment were collected,including 176 cases of infiltrating adenocarcinomas,150 cases of minimally invasive adenocarcinoma,117 cases of precursor glandular lesions and 51 cases of benign lesions.Serum CEA was collected from only 150 infiltrating adenocarcinomas,127 minimally invasive adenocarcinomas,95 precursor glandular lesions,and 45 benign lesions.The NLR,PLR,LMR,and serum CEA of each pathological group were compared.Results:The NLR of the precursor glandular lesion group(2.32±1.59)was higher than that of the benign lesion group(1.82±0.64)(P<0.05).The PLR in lung adenocarcinoma group(141.19±53.14)and in precursor glandular lesion group(145.94±51.92)was both higher than that of the benign lesion group(124.90±37.04)(all P<0.05).The CEA of lung adenocarcinoma group[1.83(1.18,2.73)ng/mL]was higher than that of the control group(precursor glandular lesions+benign lesions)[1.49(1.03,2.08)ng/mL](P<0.01).The CEA in infiltrating adenocarcinoma group[2.14(1.29,2.92)ng/mL]was higher than that of minimally invasive adenocarcinoma group[1.67(1.09,2.43)ng/mL],precursor glandular lesion group[1.46(1.03,2.06)ng/mL],and benign lesion group[1.53(1.00,2.10)ng/mL](P<0.05).Conclusion:Systemic immune inflammatory index begins to change in early-stage lung adenocarcinoma,even in the stage of precursor glandular lesions,and serum CEA begins to change in early-stage lung adenocarcinoma.Dynamic observation of the changes in the above indicators is conducive to the early detection and early intervention of malignant lesions.