肿瘤标志物和中性粒细胞与淋巴细胞比值联合检测在直肠癌诊断中的意义

目的 探讨中性粒细胞与淋巴细胞比值(NLR)和肿瘤标志物癌胚抗原(CEA)、糖类抗原199(CA19-9)联合检测在直肠癌诊断中的作用.方法 回顾性分析该院2014年1月-2016年12月52例手术切除且经术后病理证实的直肠癌患者临床病理资料.通过独立样本t检验、ROC曲线等数据分析方法,评估各个指标在直肠癌诊断中的诊断价值.结果 直肠癌患者术前血清CEA和肿瘤大小、临床分期(TNM分期)、淋巴结转移相关(P<0.05);血清CA19-9与临床资料及肿瘤各项特征无关(P>0.05);NLR和肿瘤大小、淋巴结转移相关(P<0.05).依据ROC曲线按照Youden指数确定NLR、CEA的临界值.并依此临界值进行进一步分组比较ROC曲线下面积.血清CEA、NLR检测肿瘤大小情况的AUC值分别为0.758和0.804;血清CEA、NLR检测肿瘤淋巴结转移情况的AUC值分别为0.801和0.741;两者联合检测的AUC值均高于单独检测.结论 直肠癌患者术前检测血清CEA、NLR对判断肿瘤大小、有无淋巴结转移有一定帮助,两者联合检测更有临床诊断意义.血清CA19-9对判断肿瘤特征意义不大.

Tumor markers and NLR combined detection in the diagnosis of rectal cancer

Objective To investigate the effect of NLR and tumor markers CEA and CA 19-9 combined detection in the diagnosis of rec-tal cancer.Methods Retrospective analysis of 52 cases of surgical resection and confirmed by postoperative pathology clinical patho -logical data of rectal cancer patients from 2014 to 2016.Through independent sample t test,ROC curve data analysis methods,the diag-nostic value in the various indicators in rectal cancer were evaluated.Results The patients with rectal cancer,preoperative serum CEA were relevant to tumor size,stage,lymph node metastasis(P<0.05).Preoperative serum CA19-9 has nothing to do various pathological features and clinical data(P>0.05).NLR was associated with tumor size and lymph node metastasis(P<0.05).The numerical of AUC for Serum CEA,NLR to detection of tumor size,respectively,were 0.758 and 0.804.Serum levels of tumor lymph node metastasis of the AUC numerical were respectively:0.801 and 0.741 by serum CEA,NLR detecting.And combined test the AUC value was higher than single test.Conclusions Preoperative detection of serum CEA,NLR has the valuable to evaluate tumor size,presence of lymph node metastasis.The combined detection is more meaningful.Serum levels of CA19-9 have nothing to judging tumor characteristics.