Pedersen Lars M, Milman Nils
Department of Pulmonary Medicine, Gentofte Hospital, Copenhagen, Denmark.
Oncol Rep. 2003 Jan-Feb;10(1):213-6.
The objective of this study was to evaluate the clinical value of an elevated platelet count and other routine laboratory tests for predicting malignancy in patients with radiologically suspected lung cancer. Platelet count, haemoglobin, total leukocyte count, erythrocyte sedimentation rate (ESR) and serum lactate dehydrogenase (LDH) were analysed in 126 prospectively admitted patients with suspected lung cancer. The patients were divided by pathologic diagnosis into those with benign disorders (n=65) and with malignancies (n=61). Patients with lung cancer were staged (TNM) and the tumours were classified according to histological types (WHO). Thrombocytosis (platelet count >400x10(9)/l) was present in 8% (5/65) of patients with benign disease and in 57% (35/61) of patients with malignant disease (p<0.00001). The prevalence of thrombocytosis in patients with primary lung cancer was 53% (27/51). Elevated platelet count was more common in advanced disease (stage III and IV). No difference was observed between histological types. The sensitivity of thrombocytosis for predicting malignancy was 0.57 and the specificity 0.92. When elevated platelet counts, LDH and ESR were combined, a sensitivity of 0.71 and a specificity of 1.00 was achieved. The positive and negative predictive values were 1.00 and 0.89, respectively. Elevated platelet count is frequently observed in patients with lung cancer. When test results of platelet count and other routine blood analyses are combined, a high sensitivity and specificity for predicting malignancy can be achieved. These tests are clinically useful in the evaluation of patients with radiologically suspected lung cancer.
本研究的目的是评估血小板计数升高及其他常规实验室检查对放射学怀疑患有肺癌患者预测恶性肿瘤的临床价值。对126例前瞻性收治的疑似肺癌患者的血小板计数、血红蛋白、白细胞总数、红细胞沉降率（ESR）和血清乳酸脱氢酶（LDH）进行了分析。根据病理诊断将患者分为良性疾病组（n = 65）和恶性疾病组（n = 61）。对肺癌患者进行分期（TNM），并根据组织学类型（WHO）对肿瘤进行分类。良性疾病患者中8%（5/65）存在血小板增多症（血小板计数>400x10⁹/L），恶性疾病患者中57%（35/61）存在血小板增多症（p<0.00001）。原发性肺癌患者中血小板增多症的患病率为53%（27/51）。血小板计数升高在晚期疾病（III期和IV期）中更为常见。不同组织学类型之间未观察到差异。血小板增多症预测恶性肿瘤的敏感性为0.57，特异性为0.92。当血小板计数升高、LDH和ESR联合使用时，敏感性为0.71，特异性为1.00。阳性和阴性预测值分别为1.00和0.89。肺癌患者中经常观察到血小板计数升高。当将血小板计数及其他常规血液分析的检测结果相结合时，可实现对恶性肿瘤的高敏感性和特异性预测。这些检查在评估放射学怀疑患有肺癌的患者时具有临床实用性。
