血清CA125联合NLR与PLR对子宫内膜癌的诊断价值

目的 评估术前联合检测血清糖链抗原125（carbohydrate antigen，CA125）与中性粒细胞/淋巴细胞比值（neutrophil/lymphocyte ratio，NLR）、血小板/淋巴细胞比值（platelet/lymphocyte ratio，PLR）对子宫内膜癌（endometrial cancer，EC）的诊断价值。方法 回顾性分析行子宫内膜病理检查的291例患者的临床资料，其中子宫内膜癌179例（EC组），非子宫内膜癌性病变112例（非EC组）。采用受试者工作特征曲线 （receiver operating characteristic curve，ROC）和Logistic回归分析CA125、NLR和PLR 3项指标单独及联合检测对EC的诊断价值，并分析其与EC患者临床病理特征的关系。结果 EC组CA125、NLR 和PLR水平分别为（32.73±58.43） U/mL、 2.40±1.21和 157.89±70.87，非EC组分别为（16.06±13.47） U/mL、1.87±0.54和138.88±43.07，两组比较差异有统计学意义（P<0.05）。相关分析显示，EC组CA125水平与NLR和PLR均呈正相关（r=0.171，0.146；P=0.003，0.013），PLR与NLR水平亦呈正相关（r=0.595，P<0.001）； CA125、NLR和PLR单独诊断EC的曲线下面积（AUC）分别为0.706（P＜0.001）、0.648（P=0.001）和0.555（P=0.550），3项指标联合预测EC的AUC为0.792，明显高于3项指标单独诊断EC的AUC（P<0.05）。结论 CA125联合NLR、PLR检测诊断子宫内膜癌的准确性高于单项检测。

iagnostic value of serum CA125 combined with NLR and PLR for endometrial cancer

Objective To explore the diagnostic value of carbohydrate antigen 125（CA125） serum level combined with neutrophil/lymphocyte ratio（NLR） and platelet/lymphocyte ratio （PLR） for endometrial cancer（EC）. Methods Medical records were collected and analyzed for 291 patients，179 cases of endometrial cancer and 112 cases of normal endometrium. The receiver operating characteristic curve （ROC） and logistic regression equation were used to analyze the diagnostic value of CA125，NLR and PLR ffor EC，and the relationship between CA125  serum level and clinicopathological characteristics were analyzed. Results The CA125 seum level，NLR and PLR were（32.73±58.43） U/mL， 2.40±1.21 and 157.89±70.87 in the endometrial cancer group，which were significantly higher than that in the normal endometrium group（16.06±13.47） U/mL，1.87±0.54 and 138.88±43.07（P<0.05）. Correlation analysis showed that CA125  was significantly positive correlated with NLR（r=0.171，P=0.003） and PLR（r=0.146，P=0.013），and PLR showed a significant positive correlation with NLR（r=0.595，P<0.001）. The AUCs for diagnosing EC：CA125，0.706；NLR，0.648；PLR，0.555；Combination，0.792；while the AUC of three combined showed significantly higher diagnostic accuracy than either serum CA125，NLR and PLR alone（P＜0.05）. Conclusion The accuracy of serum CA125 combined with NLR and PLR for the diagnosis of endometrial cancer is higher than that of single test.