外周血NLR、PLR和血清CEA、SCCA联合检测预测宫颈癌放化疗后复发及转移的临床价值

Clinical value of combined detection of peripheral blood neutrophil-to-lymphocyte ratio,platelet-to-lymphocyte ratio,serum carcinoembryonic antigen and squamous cell carcinoma antigen in predicting the recurrence and metastasis of cervical cancer after chemoradiotherapy

目的探讨外周血中性粒细胞与淋巴细胞比(NLR)、血小板与淋巴细胞比(PLR)和血清癌胚抗原(CEA)、鳞状细胞癌抗原(SCCA)联合检测预测宫颈癌放化疗后复发及转移的临床价值。方法选取2019年1月至2022年12月浙江金华广福肿瘤医院收治的148例宫颈癌患者作为研究对象,均接受放化疗治疗,根据复发及转移情况分为复发转移组和未复发转移组。比较两组NLR、PLR、CEA、SCCA水平,分析复发转移组NLR、PLR、CEA、SCCA水平与临床病理特征的关系,采用多因素Cox回归分析宫颈癌放化疗后复发及转移的影响因素,采用受试者工作特征(ROC)曲线分析NLR、PLR、CEA、SCCA单独及联合检测对宫颈癌放化疗后复发及转移的预测价值。结果148例宫颈癌患者中复发转移发生率为27.70%(41/148)。复发转移组NLR、PLR、CEA、SCCA水平均高于未复发转移组(P<0.05)。复发转移组NLR、PLR、CEA、SCCA水平与国际妇产科联盟(FIGO)分期和卡氏功能状态评分标准(KPS)评分相关(P<0.05)。FIGO分期、KPS评分、NLR、PLR、CEA、SCCA是影响患者复发转移的独立危险因素(P<0.05)。NLR、PLR、CEA、SCCA联合检测的预测效能高于单独检测(P<0.05)。结论宫颈癌行同步放化疗后复发转移风险与多个因素相关,患者NLR、PLR、CEA、SCCA水平越高复发转移风险越高。上述指标联合检测具有较高的预测效能,可更准确地预测宫颈癌复发情况。

Objective To explore the clinical value of combined detection of peripheral blood neutrophil-to-lymphocyte ratio(NLR),platelet-to-lymphocyte ratio(PLR),serum carcinoembryonic antigen(CEA)and serum squamous cell carcinoma antigen(SCCA)in predicting the recurrence and metastasis of cervical cancer after chemoradiotherapy.Methods A total of 148 patients with cervical cancer admitted to Zhejiang Jinhua Guangfu Oncology Hospital from January 2019 to December 2022 were selected as the study objects,and they all received chemoradiotherapy.According to the conditions of recurrence and metastasis,the patients were classified into recurrence-metastasis group and non-recurrence-metastasis group.The NLR,PLR,CEA and SCCA levels were compared between the two groups.The relationship between NLR,PLR,CEA and SCCA levels and the clinicopathological features in the recurrence-metastasis group was analyzed.Multivariate Cox regression analysis was applied to analyze the influencing factors of the recurrence and metastasis of cervical cancer after chemoradiotherapy.The predictive ralue of NLR,PLR,CEA and SCCA alone and in combination on the recurrence and metastasis of cervical cancer after chemoradiotherapy was analyzed by receiver operating characteristic(ROC)curve.Results The incidence rate of recurrence and metastasis in 148 patients with cervical cancer was 27.70%(41/148).The levels of NLR,PLR,CEA and SCCA in the recurrence-metastasis group were all higher than those in the non-recurrence-metastasis group(P<0.05).The levels of NLR,PLR,CEA and SCCA in the recurrence-metastasis group were correlated with federation international of gynecology and obstetrics(FIGO)staging and Karnofsky performance status(KPS)score(P<0.05).The FIGO staging,KPS score,NLR,PLR,CEA and SCCA were independent risk factors influencing the recurrence and metastasis of patients(P<0.05).The prediction efficiency of the combined detection of NLR,PLR,CEA and SCCA was higher than that of single detection(P<0.05).Conclusions The risk of recurrence and metastasis of cervical cancer after concurrent chemoradiotherapy is related to multiple factors.The higher NLR,PLR,CEA and SCCA levels of patients,the greater the risk of recurrence and metastasis.The combined detection of the above indicators have higher predictive efficiency,and can predict the recurrence condition of cervical cancer more accurately.