中性粒细胞与淋巴细胞比值、血小板与淋巴细胞比值及平均血小板体积联合肿瘤标志物检测对小细胞肺癌的诊疗价值

The diagnostic value of neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio and mean platelet volume combined with tumor marker detection in small cell lung cancer

目的旨在探讨中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)及平均血小板体积(MPV)联合肿瘤标志物检测对小细胞肺癌的诊疗价值。方法回顾性分析207例小细胞肺癌患者及207例体检者肿瘤标志物神经元特异性烯醇化酶(NSE)、胃泌素释放肽前体(pro GRP)和炎性指标NLR、PLR、MPV的检测数据,比较不同分期、治疗前后检测结果的差异,采用ROC曲线评估单项和联合指标对小细胞肺癌的诊断价值。结果小细胞肺癌患者广泛期和局限期5项指标均存在统计学差异(P<0.05)。首次治疗后proGRP、NSE、NLR、PLR和MPV分别下降了73.17%、59.53%、31.52%、11.89%和3.00%,均存在统计学差异(P<0.05)。NSE和pro GRP联合检测敏感度为89.40%,特异度为93.20%,约登指数为0.826,高于单独检测。NSE+proGRP联合NLR、PLR、MPV和NSE+proGRP相比,诊断价值不存在统计学差异(P>0.05)。结论肿瘤标志物NSE和pro GRP联合检测对小细胞肺癌的诊断价值高于单独检测,联合炎性指标NLR、PLR、MPV诊断价值未有明显提升,但NLR、PLR、MPV均可用于小细胞肺癌治疗效果评估。

Objective The purpose of this study was to investigate the diagnostic value of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR)and mean platelet volume(MPV)combined with tumor marker detection for small cell lung cancer.Methods The detection data of tumor markers neuron-specific enolase(NSE),pro-gastrin-releasing peptide(pro GRP)and inflammatory indicators NLR,PLR and MPV in 207 patients with small cell lung cancer and normal control were retrospectively analyzed;the differences in detection results between different stages and treatment process were compared,and ROC curves were used to evaluate the diagnostic value of single and combined indicators for small cell lung cancer.Results There were significant differences in the five indicators between the extensive stage and the limited stage of patients with small cell lung cancer(P<0.05).After the first treatment,pro GRP,NSE,NLR,PLR and MPV decreased by 73.17%,59.53%,31.52%,11.89%and 3.00%,respectively(P<0.05).The combined detection sensitivity of NSE and proGRP was 89.40%,the specificity was 93.20%,and the Youden index was 0.826,which was higher than the single detection.There was no statistical difference in the diagnostic value of NSE+proGRP combined with NLR,PLR,MPV and NSE+proGRP(P>0.05).Conclusion The diagnostic value of NSE combined with proGRP was higher than single detection in small cell lung cancer.The diagnostic value of NLR,PLR and MPV combined with NSE+proGRP did not improve significantly.However,NLR,PLR and MPV could all be used to evaluate the therapeutic effect of small cell lung cancer.