高分辨率CT肺气肿指标联合血清CEA、NLR、PLR对慢性阻塞性肺疾病患者非小细胞肺癌发生风险的预测价值

Predictive Value of High-Resolution CT Emphysema Index Combined with Serum CEA,NLR and PLR for the Risk of Non-Small Cell Lung Cancer in Patients with Chronic Obstructive Pulmonary Disease

目的:分析高分辨率CT(HRCT)肺气肿指标联合血清癌胚抗原(CEA)、中性粒细胞/淋巴细胞(NLR)、血小板/淋巴细胞(PLR)对慢性阻塞性肺疾病(COPD)患者非小细胞肺癌(NSCLC)发生风险的预测价值。方法:选择2020年6月至2023年3月新疆维吾尔自治区中医医院收治的120例COPD合并NSCLC患者作为合并组,80例单纯NSCLC患者作为NSCLC组、80例单纯COPD患者作为COPD组。对比三组HRCT肺气肿指标[肺气肿指数(EI)、肺气肿Goddard评分]、CEA、NLR、PLR。受试者工作特征(ROC)曲线分析HRCT肺气肿指标、CEA、NLR、PLR预测COPD患者NSCLC发生风险的价值。结果:合并组血清CEA、NLR、PLR高于NSCLC组、COPD组,且NSCLC组高于COPD组(P<0.05);合并组Goddard评分、EI高于COPD组、NSCLC组,且COPD组高于NSCLC组(P<0.05)。ROC曲线发现,CEA、NLR、PLR、Goddard评分、EI及五者联合预测COPD合并NSCLC发生的ROC曲线下的面积(AUC)分别为0.833、0.835、0.771、0.824、0.813、0.991。结论:COPD合并NSCLC患者HRCT肺气肿指标及血清CEA、NLR、PLR升高。HRCT肺气肿指标联合CEA、NLR、PLR可有效预测COPD合并NSCLC的发生。

Objective:To analyze the predictive value of high-resolution CT(HRCT)emphysema index combined with serum carcinoembryonic antigen(CEA),neutrophil/lymphocyte(NLR),platelet/lymphocyte(PLR)on the risk of non-small cell lung cancer(NSCLC)in patients with chronic obstructive pulmonary disease(COPD).Methods:Selected 120 patients with COPD complicated with NSCLC who were admitted to Xinjiang Uygur Autonomous Region Traditional Chinese Medicine Hospital from June 2020 to March 2023 were selected as combined group,80 patients with NSCLC alone were selected as NSCLC group,and 80 patients with COPD alone were selected as COPD group.The HRCT emphysema indexes[emphysema index(EI),emphysema Goddard score],CEA,NLR,PLR were compared among three groups.The value of HRCT emphysema index,CEA,NLR and PLR in predicting the risk of NSCLC in COPD patients were analyzed by receiver operating characteristic(ROC)curve.Results:Serum levels of CEA,NLR,and PLR were greater in combined group than in NSCLC group and COPD group,with NSCLC group had higher levels than COPD group(P<0.05).The combined group's Goddard score and EI were greater than those in COPD group and NSCLC group,and COPD group was higher than NSCLC group(P<0.05).ROC curve showed that,the area under the ROC curve(AUC)of CEA,NLR,PLR,Goddard score,EI and the combination of the five in predicting the occurrence of COPD combined with NSCLC was 0.833,0.835,0.771,0.824,0.813 and 0.991,respectively.Conclusion:HRCT emphysema index and serum CEA,NLR and PLR are increase in COPD patients with NSCLC.HRCT emphysema index combined with CEA,NLR and PLR can effectively predict the occurrence of COPD combined with NSCLC.