术前炎症指标、凝血指标及肿瘤标志物鉴别卵巢良恶性肿瘤的临床价值

Clinical value of preoperative inflammatory indexes,coagulation indexes and tumor biomarkers in differentiating benign and malignant ovarian tumors

目的探讨术前炎症指标、凝血指标及肿瘤标志物鉴别卵巢良、恶性肿瘤的临床价值。方法回顾性分析2018年1月—2021年12月在本院就诊的60例早期卵巢癌(恶性组)及30例卵巢良性肿瘤(良性组)患者的病例资料。比较两组患者外周血炎症指标、凝血指标及肿瘤标志物水平;采用受试者工作特征(ROC)曲线分析联合检测对良恶性卵巢肿瘤辅助诊断的价值。结果炎症指标中,恶性组患者的中性粒细胞、中性粒细胞-淋巴细胞比值(NLR)、血小板-淋巴细胞比值(PLR)、C反应蛋白(CPR)水平均明显高于良性组(P<0.05),而淋巴细胞水平明显低于良性组(P<0.05)。凝血指标中,恶性组患者的凝血酶原时间(PT)和纤维蛋白原水平明显高于良性组(P<0.05)。肿瘤标志物中,恶性组患者的CA125水平明显高于良性组(P<0.05)。此外,联合评估NLR、纤维蛋白原和CA125水平对卵巢癌诊断的ROC曲线下面积为0.941,诊断价值更高。结论联合评估NLR、纤维蛋白原和CA125水平比单项指标检测对良恶性卵巢肿瘤具有更高的辅助诊断价值。

Objective To investigate the clinical value of preoperative inflammatory indexes,coagulation indexes and tumor biomarkers in differentiating benign and malignant ovarian tumors.Methods The clinical data of 60 samples with ovarian cancer at early stage(malignant group)and 30 benign ovarian tumor samples(benign group)treated in the affiliated Wuxi people’s hospital of Nanjing Medical University from January 2018 to December 2021 were retrospectively analyzed.The levels of inflammatory indexes,coagulation indexes and tumor biomarkers in peripheral blood were compared between between the two groups.Receiver operating characteristic(ROC)curve was used to analyze the value of combined detection in the auxiliary diagnosis of benign and malignant ovarian tumors.Results Among inflammatory indexes,the levels of neutrophil,neutrophil-lymphocyte ratio(NLR),platelet-lymphocyte ratio(PLR),and C-reactive protein(CPR)in the malignant group were significantly higher than those in the benign group.Lymphocyte levels were significantly lower than those in the benign group.Among the coagulation indexes,the prothrombin time(PT)and fibrinogen levels in the malignant group were significantly higher than those in the benign group.Among tumor biomarkers,the CA125 level in the malignant group was significantly higher than that in the benign group.In addition,the area under the ROC curve of the combined assessment of NLR,fibrinogen,and CA125 levels for the diagnosis of ovarian cancer was 0.941,indicating a higher diagnostic value.Conclusions Combined assessment of NLR,fibrinogen,and CA125 levels has higher auxiliary diagnostic value for benign and malignant ovarian tumors than single index detection.