超声特征联合炎症指标在膀胱尿路上皮癌分级中的应用价值

Application value of ultrasound features combined with inflammatory markers in bladder urothelial carcinoma grading

目的:探讨超声特征联合炎症指标在膀胱尿路上皮癌(bladder urothelial carcinoma,BUC)分级中的应用价值。方法:回顾并分析2021年3月—2022年9月于兰州大学第二医院就诊并具有病理学检查结果的95例BUC患者的超声特征,根据病理学检查结果将其分为高级别组(n=65)和低级别组(n=30),分别比较两组患者的一般资料、超声特征和炎症指标。绘制受试者工作特征(receiver operating characteristic,ROC)曲线评价超声特征联合炎症指标对低、高级别BUC的诊断效能。结果:两组间患者年龄(t=0.570,P=0.001)、病灶横径(t=-4.158,P=0.000)、病灶纵径(t=-3.932,P=0.000)、血流分级(χ2=10.454,P=0.005)及中性粒细胞与淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)(Z=-2.210,P=0.027)比较差异均有统计学意义(P<0.05)。Logistic回归分析显示,年龄(OR=3.360,P=0.024)和NLR(OR=3.303,P=0.029)是高级别BUC的独立危险因素。超声特征联合炎症指标诊断高级别BUC的ROC曲线的曲线下面积、灵敏度、特异度分别为0.823、81.5%、73.3%。结论:超声特征联合炎症指标在BUC分级中具有一定价值。

Objective:To investigate the application value of ultrasonography features combined with inflammatory markers in bladder urothelial carcinoma(BUC)grading.Methods:The ultrasound features of 95 patients with BUC diagnosed by pathological findings in Lanzhou University Second Hospital from March 2021 to September 2022 were retrospectively analyzed.According to the pathological results,the patients were divided into high-grade group(n=65)and low-grade group(n=30),and the general data,ultrasound characteristics and inflammatory markers were compared between the two groups.Receiver operating characteristic(ROC)curves were plotted to evaluate the diagnostic efficacy of ultrasound characteristics combined with inflammatory markers for low-grade and high-grade BUC.Results:There were significant differences in age(t=0.570,P=0.001),transverse diameter(t=-4.158,P=0.000),longitudinal diameter(t=-3.932,P=0.000),blood flow grade(χ2=10.454,P=0.005)and NLR(Z=-2.210,P=0.027)between the two groups(P<0.05).Logistic regression analysis showed that age(OR=3.360,P=0.024)and neutrophil to lymphocyte ratio(NLR)(OR=3.303,P=0.029)were independent risk factors for high-grade BUC.The area under the ROC curve,sensitivity,and specificity of ultrasound features combined with inflammatory markers in differentiating high-grade BUC were 0.823,81.5%,73.3%.Conclusion:Ultrasonography characteristics combined with inflammatory markers has certain value in the BUC grading.