NLR、PLR、MLR、SII在结直肠癌诊断中的应用价值

Application Value of NLR,PLR,MLR and SII in the Diagnosis of Colorectal Cancer

目的探讨中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、单核细胞与淋巴细胞比值(MLR)、系统炎症指数(SII)在结直肠癌的诊断中的应用价值。方法回顾性分析2021年1月-2023年5月安徽医科大学附属巢湖医院住院的结直肠癌(CRC)、结直肠癌前病变及结直肠息肉患者分别作为CRC组、癌前病变组、息肉组,检测三组NLR、PLR、MLR、SII水平,并分析NLR、PLR、MLR、SII在CRC中的诊断价值。结果CRC组NLR、PLR、MLR、SII水平均高于癌前病变组及息肉组(P<0.05)。ROC曲线分析显示,PLR敏感度最高,MLR特异度最高,NLR诊断CRC与非CRC的最佳取值为2.77,ROC曲线下面积为0.638(0.570~0.705),敏感度为51.60%,特异度为76.10%;PLR诊断CRC与非CRC的最佳取值为143.49,ROC曲线下面积为0.648(0.581~0.714),敏感度为57.10%,特异度为70.70%。NLR、PLR、MLR、SII四项指标综合诊断CRC的ROC曲线下面积均大于血清标志物单独及联合应用,且敏感度最高;Logistic回归分析显示,PLR、MLR是预测TNMⅠ+Ⅱ期CRC的独立危险因素。结论NLR、PLR、MLR、SII可提高CRC的检出率,对CRC分期诊断有预测价值。

Objective To investigate the application value of neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),monocyte-to-lymphocyte ratio(MLR)and systemic inflammatory index(SII)in the diagnosis of colorectal cancer.Methods Patients with colorectal cancer(CRC),colorectal precancerous lesions and colorectal polyps hospitalized in Chaohu Hospital of Anhui Medical University from January 2021 to May 2023 were retrospectively analyzed as CRC group,precancerous lesion group and polyp group.The levels of NLR,PLR,MLR and SII in the three groups were detected,and the diagnostic value of NLR,PLR,MLR and SII in CRC was analyzed.Results The levels of NLR,PLR,MLR and SII in CRC group were higher than those in precancerous lesion group and polyp group(P<0.05).ROC curve analysis showed that PLR had the highest sensitivity and MLR had the highest specificity.The best value of NLR for diagnosing CRC and non-CRC was 2.77,the area under the ROC curve was 0.638(0.570-0.705),the sensitivity was 51.60%,and the specificity was 76.10%.The optimal value of PLR in the diagnosis of CRC and non-CRC was 143.49,the area under the ROC curve was 0.648(0.581-0.714),the sensitivity was 57.10%,and the specificity was 70.70%.The area under the ROC curve of NLR,PLR,MLR and SII in the comprehensive diagnosis of CRC was greater than that of serum markers alone and in combination,and the sensitivity was the highest.Logistic regression analysis showed that PLR and MLR were independent risk factors for predicting TNM stageⅠ+ⅡCRC.Conclusion NLR,PLR,MLR and SII can improve the detection rate of CRC and have predictive value for CRC staging diagnosis.