白细胞衍生性指标联合检测对恶性肿瘤患者化疗后感染的预测价值

Predictive value of leukocyte derived markers combined detection for infection in malignant tumor patients after chemotherapy

目的 探讨白细胞衍生性指标[中性粒细胞与淋巴细胞比值(NLR)、淋巴细胞与单核细胞比值(LMR)和血小板与淋巴细胞比值(PLR)]联合检测对恶性肿瘤患者化疗后感染的预测价值。方法 选取115例恶性肿瘤患者,依据化疗后发生感染与否分为感染组(n=80)与未感染组(n=35),比较感染与未感染组、不同感染类型恶性肿瘤化疗患者的NLR、PLR、LMR。绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估NLR、PLR、LMR单独及联合检测对恶性肿瘤患者化疗后感染的预测效能。结果 感染组患者NLR、PLR均明显高于未感染组,LMR明显低于未感染组,差异均有统计学意义(P﹤0.01)。感染组恶性肿瘤化疗患者中,细菌感染42例,病毒感染20例,混合感染18例。细菌感染患者NLR、PLR均高于病毒感染和混合感染患者,LMR低于病毒感染和混合感染患者,且混合感染患者NLR、PLR均高于病毒感染患者,LMR低于病毒感染患者,差异均有统计学意义(P﹤0.05)。ROC曲线显示,NLR、PLR、LMR联合检测预测恶性肿瘤患者化疗后感染的AUC为0.949(95%CI:0.905~0.993),特异度为0.947,均高于各指标单独检测。结论 白细胞衍生性指标NLR、PLR及LMR联合检测预测恶性肿瘤患者化疗后感染的价值较高,可作为评估恶性肿瘤患者化疗后感染的有效指标。

Objective To explore the predictive value of leukocyte derived markers[neutrophil-to-lymphocyte ratio(NLR),lymphocyte-to-monocyte ratio(LMR),platelet-to-lymphocyte ratio(PLR)]combined detection for infection in malignant tumor patients after chemotherapy.Method A total of 115 malignant tumor patients after chemotherapy were selected and divided into infected group(n=80)and uninfected group(n=35)based on whether infection occurred after chemotherapy.The NLR,PLR,and LMR were compared between the infected and uninfected groups,as well as malig-nant tumor chemotherapy patients with different infection types.The receiver operating characteristic(ROC)curve was drawn,the area under the curve(AUC)was calculated,and the predictive efficacy of NLR,PLR,and LMR single and combined detection for infection in malignant tumor patients after chemotherapy were evaluated.Result The NLR and PLR of the infected group were significantly higher than those of the uninfected group,while the LMR was significantly lower than that of the uninfected group,and the differences were statistically significant(P<0.01).Among the malignant tumor chemotherapy patients in the infection group,there were 42 cases of bacterial infection,20 cases of viral infection,and 18 cases of mixed infection.The NLR and PLR of bacterial infection patients were higher than those of viral infec-tion and mixed infection patients,and the LMR was lower than that of viral infection and mixed infection patients,in ad-dition,the NLR and PLR of mixed infection patients were higher than those of viral infection patients,and the LMR was lower than that of viral infection patients,and the differences were statistically significant(P<0.05).ROC curve showed that the AUC of NLR,PLR,and LMR combined detection in predicting infection in malignant tumor patients after che-motherapy was 0.949(95%CI:0.905-0.993),specificity was 0.947,which were higher than the single detection of each in-dicator.Conclusion The leukocyte derived markers NLR,PLR,and LMR combined detection has high value in predict-ing infection in malignant tumor patients after chemotherapy,and can be used as effective indicators for evaluating infec-tion in malignant tumor patients after chemotherapy.