联合检测低密度脂蛋白胆固醇与高密度脂蛋白胆固醇比值和NLR在乳腺癌筛查中的临床意义

Clinical significance of combined detection of low density lipoprotein cholesterol/high-density lipoprotein cholesterol ratio and neutrophil to lymphocyte ratio in screening breast cancer

目的探讨低密度脂蛋白胆固醇(LDL-C)与高密度脂蛋白胆固醇(HDL-C)比值和中性粒细胞与淋巴细胞比值(NLR)在乳腺癌筛查中的临床意义。方法收集2018年1月—2022年12月在浙江中医药大学附属第一医院确诊为乳腺癌的患者(147例)以及年龄匹配的健康对照者(154例)的临床资料,对其血脂水平、部分肿瘤标志物和炎症指标等检查结果进行统计学分析;采用二元logistic回归进行多因素分析;通过ROC曲线确定最优指标。结果乳腺癌患者的总胆固醇(TC)、LDL-C水平和LDL-C/HDL-C比值低于对照组,HDL-C和NLR水平高于对照组,差异均有统计学意义(P<0.05)。LDL-C/HDL-C比值与TC、LDL-C以及HDL-C成正相关(P<0.05),而LDL-C/HDL-C与NLR无相关性(P>0.05)。LDL-C/HDL-C比值为乳腺癌的保护因素,NLR为乳腺癌的危险因素(P<0.05);LDL-C/HDL-C比值和NLR联合指标诊断鉴别乳腺癌的灵敏度和特异度分别为0.667和0.740。结论联合检测血清中的LDL-C/HDL-C和NLR在乳腺癌的早期筛查中具有一定的临床指导意义。

Objective This paper aims to explore the clinical value of low density lipoprotein cholesterol(LDL-C)/high-density lipoprotein cholesterol(HDL-C)ratio and neutrophil to lymphocyte ratio(NLR)in breast cancer.Methods Clinical data of 147 patients diagnosed with breast cancer in the First Affiliated Hospital of Zhejiang Chinese Medical University from January 2018 to December 2022 and age-matched healthy controls(154 cases)were collected.The blood lipid levels,some tumor markers and inflammatory indicators were statistically analyzed.Multivariate analysis was carried out by binary logistic regression.The optimal index was determined by ROC curve.Results The levels of total cholesterol(TC),LDL-C and LDL-C/HDL-C ratio in patients with breast cancer were lower than those in the controls,while the levels of HDL-C and NLR in breast cancer patients were higher than those in the controls,and the difference were statistically significant(P<0.05).There was a positive correlation between LDL-C/HDL-C ratio and TC,LDL-C and HDL-C(P<0.05),while there was no correlation between LDL-C/HDL-C and NLR(P>0.05).LDL-C/HDL-C ratio was the protective factor for breast cancer,while NLR was risk factors for breast cancer(P<0.05).The sensitivity and specificity of LDL-C/HDL-C ratio and NLR combined index in the diagnosis and differential diagnosis of breast cancer were 0.667 and 0.740 respectively.Conclusion The combined detection of serum LDL-C/HDL-C ratio and NLR have certain clinical significance in the early screening of breast cancer.