NLR、PLR、CEA、CYFRA 21-1检测在食管癌诊断中的价值

The Value of NLR,PLR,CEA and CYFRA21-1 Detection in the Diagnosis of Esophageal Cancer

目的:分析食管癌(esophageal cancer,EC)患者中性粒细胞/淋巴细胞比值(neutrophil to lymphocyte ratio,NLR)、血小板/淋巴细胞比值(platelet to lymphocyte ratio,PLR)以及癌胚抗原(carcino-embryonic antigen,CEA)、细胞角蛋白19片段(cytokerantin19-fragment,CYFRA 21-1)的水平与临床病理特征之间的关系,探讨各指标对EC诊断的临床意义。方法:收集食管鳞癌患者127例,同期健康体检者100例。比较两组NLR、PLR、CEA、Cyfra21-1的水平,分析各指标与EC临床病理特征之间的关系。采用受试者工作曲线(ROC)分析NLR、PLR、CEA、Cyfra21-1诊断EC的效能。结果:⑴食管癌组患者NLR、PLR、CEA、Cyfra21-1水平明显高于对照组(P<0.05);⑵发生淋巴结转移、TNM分期在Ⅲ+Ⅳ期、浸润深度为T3+T4的患者PLR、CEA、Cyfra21-1水平高于未发生淋巴结转移、TNM分期在Ⅰ+Ⅱ期、浸润深度为T1+T2的患者(P<0.05),NLR水平与淋巴结转移、TNM分期、分化程度有关;⑶NLR、PLR、CEA、Cyfra21-1诊断EC的曲线下面积(AUC)分别为0.803、0.770、0.655、0.716(P<0.05),四项联合检测的AUC为0.875,高于单项检测(P<0.05)。结论:NLR、PLR、CEA、Cyfra21-1在EC患者中明显升高,且与EC的临床病理特征有关,四项联合检测对EC的诊断价值高于单项检测。

Objective To analyze the relationship between the levels of neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),CEA,Cyfra21-1 and clinicopathological features in patients with esophageal cancer(EC),and to explore the clinical significance of each index in the diagnosis of EC.Methods A total of 127 patients with esophageal squamous cell carcinoma and 100 healthy subjects were collected during the same period.The levels of NLR,PLR,CEA and Cyfra21-1 were compared between the two groups,and the relationship between each index and the clinicopathological features of EC was analyzed.The receiver operating curve(ROC)was used to analyze the efficacy of NLR,PLR,CEA and Cyfra21-1 in the diagnosis of EC.Results⑴The levels of NLR,PLR,CEA and Cyfra21-1 in esophageal cancer group were significantly higher than those in control group.⑵The levels of PLR,CEA and Cyfra21-1 in patients with lymph node metastasis,TNM staging in stage III+IV,and infiltration depth of T3+T4 were higher than those without lymph node metastasis,TNM staging in stage Ⅰ+Ⅱ,and infiltration depth of T1+T2(P<0.05).The level of NLR was related to lymph node metastasis,TNM staging and degree of differentiation.⑶The area under the curve(AUC)of NLR,PLR,CEA and Cyfra21-1 for diagnosing EC were 0.803,0.770,0.655 and 0.716,respectively.The AUC of the four combined tests was 0875,which was higher than that of the single test.Conclusion NLR,PLR,CEA,and Cyfra21-1 are significantly elevated in EC patients and are related to the clinical and pathological characteristics of EC.The diagnostic value of the four combined tests for EC is higher than that of individual tests.