超声血流参数及血清β2-MG LDH对非霍奇金淋巴瘤的诊断效能及疗效预测效能

Efficiency of ultrasonic blood flow parameters andβ2-MG LDH in diagnosis and prediction of curative effect for non-Hodgkin lymphoma

目的探讨超声血流参数及血清β2微球蛋白(β2-MG)、乳酸脱氢酶(LDH)对非霍奇金淋巴瘤(NHL)的诊断效能及疗效预测效能。方法选取90例NHL患者设为研究组,90例淋巴结良性肿瘤患者设为对照组,两组患者入院后均给予超声检查,并测定血清β2-MG、LDH水平。比较两组超声血流参数[脉动指数(PI)、阻力指数(RI)]及血清β2-MG、LDH水平,比较不同病理特征、疗效NHL患者上述指标的差异。分析超声血流参数及血清β2-MG、LDH水平与病理特征关联性、对NHL的诊断价值及疗效预测价值。结果研究组患者超声血流参数PI、RI及血清β2-MG、LDH水平均高于对照组(P<0.01);随着肿瘤分化程度增高,PI、RI及血清β2-MG、LDH水平持续降低,随着疾病分期增高、病情加剧,PI、RI及血清β2-MG、LDH水平持续增高(P<0.01)。Pearson相关分析显示,PI、RI及血清β2-MG、LDH水平与肿瘤分化程度呈显著负相关(P<0.01),与疾病分期、病情程度呈显著正相关(P<0.01)。疗效良好者超声血流参数PI、RI及血清β2-MG、LDH水平低于疗效不佳者(P<0.01)。受试者工作特征(ROC)曲线显示,各指标联合诊断的曲线下面积(AUC)为0.901,高于单独诊断,联合诊断敏感度为81.11%、特异度为86.67%;各指标联合预测NHL疗效不佳的AUC为0.892,高于单独预测,联合预测敏感度为80.95%、特异度为85.51%。结论超声血流参数及血清β2-MG、LDH水平均与NHL病理特征有关,联合检测可提高诊断效能,并可有效预测疗效,可指导临床诊治及病情监测。

Objective To explore the diagnostic efficacy and clinical detection significance of ultrasound blood flow parameters(UBFP)and β2-microglobulin(β2-MG)and lactate dehydrogenase(LDH)for non-Hodgkin lymphoma(NHL).Methods Ninety NHL patients were assigned as research group and 90 ones with benign lymph node tumors as control group,patients of both groups received ultrasound examination after admission,and β2-MG and LDH levels were measured.The UBFPs[pulsatility index(PI),resistance index(RI)]as well as β2-MG and LDH levels were compared between two groups,so were differences in above-mentioned parameters among NHL patients with different pathological features and curative effects.The relationships of the UBFPs,β2-MG and LDH with pathological features and their values of diagnosis and prediction of curative effect to the NHL were analyzed.Results The PI,RI,and serum β2-MG and LDH level were all higher in research than control group,difference was statistically significant(P<0.01);with the degree of tumor differentiation increased the PI,RI,and serum β2-MG,and LDH level continued to decrease,with the staging of disease increased and patients'conditions aggravated the PI,RI,and serum β2-MG,and LDH level continued to increase(P<0.01).Pearson correlation analysis showed that PI,RI,serum β2-MG and LDH were significantly negatively correlated with differentiation tumor degree(P<0.01)and positively with the staging of disease and illness degrees(P<0.01).The PI,RI,and serum β2-MG and LDH level were lower in patients with good efficacy than ones with poor efficacy(P<0.01);the receiver operating characteristic(ROC)curve showed that the area under the curve(AUC)of combined diagnosis of various parameters was 0.901 and higher than that of separate diagnosis,the sensitivity and specificity of combined diagnosis were respectively 81.11% and 86.67%;the AUC of combined parameters prediction in NHL patients with poor efficacy was 0.892 and was higher than that of separate prediction,the sensitivity and specificity of combined prediction were respectively 80.95% and 85.51%.Conclusion The UBFP as well as serum β2-MG and LDH are all related to pathological characteristics of the NHL,combined detection can improve diagnostic efficacy,effectively predict curative effect,and guide clinical diagnosis and illness monitoring.