术前NLR、Tg水平对甲状腺乳头状癌颈部淋巴结转移的评估价值

Application of Preoperative NLR and Tg Levels in the Assessment of Cervical Lymph Node Metastasis of Papillary Thyroid Carcinoma

目的探究术前外周血中性粒细胞和淋巴细胞比值(NLR)、甲状腺球蛋白(Tg)水平与甲状腺乳头状癌(PTC)临床病理关系,并评估术前NLR、Tg水平对颈部淋巴结转移评估的价值。方法回顾性分析2020年6月-2022年6月漯河市中医院收治的甲状腺乳头状癌患者76例的临床资料。所有患者术前均检测血清NLR、Tg水平,以线性回归分析术前血清NLR、Tg水平与临床病理的关系,以ROC曲线评估术前NLR、Tg水平对PTC颈部淋巴结转移的价值。结果术前NLR、Tg水平在肿瘤直径、临床分期、转移类型及腺外侵犯上差异具有统计学意义(P<0.05)。Spearman相关性分析显示,术前NLR、Tg水平与PTC患者转移类型呈显著正相关(r=0.719、0.860,P<0.05)。线性回归分析显示,转移类型可对术前NLR、Tg水平产生正向影响(B=0.631、20.871),即淋巴结转移程度越高,PTC患者术前NLR、Tg水平越高(P<0.05)。ROC曲线分析显示,术前NLR、Tg水平诊断甲状腺乳头状癌颈部淋巴结转移的AUC为0.937、0.942,准确性较高。结论术前血清NLR、Tg水平异常升高均与PTC患者颈部淋巴结转移的发生密切相关,且二者对颈部淋巴结转移的价值高,可作为PTC患者颈部淋巴结转移的有效评估指标,对临床制订针对性干预方案具有一定的指导意义。

Objective To explore the preoperative peripheral blood neutrophil to lymphocyte ratio(NLR),thyroglobulin(Tg)level and the clinicopathological relationship of papillary thyroid carcinoma(PTC),and evaluate the value of preoperative NLR and Tg levels in the assessment of cervical lymph node metastasis.Methods The clinical data of 76patients with papillary thyroid carcinoma admitted to our hospital from June 2020 to June2022 were retrospectively analyzed.All patients were tested for serum NLR and Tg levels before operation,and the relationship between preoperative serum NLR and Tg levels and clinical pathology was analyzed by linear regression analysis,and the value of preoperative NLR and Tg levels on PTC cervical lymph node metastasis was evaluated by ROC curve.Results There was no statistically significant difference in preoperative NLR and Tg levels in gender,age,and number of lesions in PTC patients(P>0.05),but there were statistically significant differences in tumor diameter,clinical stage,metastasis type,and extraglandular invasion(P<0.05).Spearman correlation analysis showed that preoperative NLR and Tg levels were significantly positively correlated with the type of metastasis in PTC patients(r=0.719,0.860,P<0.05).Linear regression analysis showed that the type of metastasis can have a positive influence on the preoperative NLR and Tg levels(B=0.631,20.871).The higher the degree of lymph node metastasis,the higher the preoperative NLR and Tg levels in PTC patients(P<0.05).ROC curve analysis showed that the AUC of preoperative NLR and Tg levels for diagnosis of cervical lymph node metastasis of papillary thyroid carcinoma was 0.937 and 0.942,which was highly accurate.Conclusion The abnormal increase of preoperative serum NLR and Tg levels are closely related to the occurrence of cervical lymph node metastasis in patients with PTC,and the two are of high value for cervical lymph node metastasis,and can be used as effective evaluation indicators for cervical lymph node metastasis in PTC patients.The formulation of targeted intervention programs has certain guiding significance.