红细胞分布宽度、中性粒细胞与淋巴细胞比值及血红蛋白与红细胞分布宽度比值与非小细胞肺癌进展的相关性。
The value of red blood cell distribution width, neutrophil-to-lymphocyte ratio, and hemoglobin-to-red blood cell distribution width ratio in the progression of non-small cell lung cancer.
机构信息
Department of Respiratory Medicine, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, People's Republic of China.
Postgraduate in Respiratory Medicine, The Second Affiliated Hospital of Nantong University, Nantong, Jiangsu, People's Republic of China.
出版信息
PLoS One. 2020 Aug 24;15(8):e0237947. doi: 10.1371/journal.pone.0237947. eCollection 2020.
BACKGROUND
Lung cancer is the leading cause of cancer-related deaths worldwide, with non-small cell lung cancer (NSCLC) accounting for 85% of all lung cancer cases. Inflammation has been proven to be one of the characteristics of malignant tumors. Chronic inflammatory response mediated by cytokines in the tumor microenvironment is an important factor in tumorigenesis. The purpose of this study was to observe and evaluate the value of red blood cell distribution width (RDW), neutrophil-to-lymphocyte ratio (NLR), and hemoglobin-to-red blood cell distribution width ratio (HRR) in the progression of NSCLC.
METHODS
A total of 245 patients with NSCLC, 97 patients with benign pulmonary nodules, and 94 healthy volunteers were included in this study. Factors, such as age, gender, smoking history, histological type, lymph node metastasis, distant metastasis, TNM stage, and differentiation degree were statistically analyzed. The correlation of RDW, NLR, and HRR of patients with NSCLC with other clinical experimental parameters were also analyzed. Then, the diagnostic value of RDW, NLR, and HRR in the progression of NSCLC was evaluated.
RESULTS
RDW, NLR, and HRR could be used to distinguish patients with NSCLC from healthy controls (p < 0.05). In addition, only the RDW in the NSCLC group with III-IV stage was significantly different from that in the benign pulmonary nodules group (p = 0.033), while NLR and HRR could significantly distinguish patients with NSCLC and benign pulmonary nodules (p < 0.001). RDW and NLR were positively correlated with NSCLC stage, whereas HRR was negatively correlated with NSCLC stage. RDW, NLR, and HRR were also significantly associated with the differentiation degree of NSCLC (p < 0.05). The ROC curve analysis showed that the combination of RDW with NLR, HRR, and CEA could show significantly higher diagnostic value than any one marker alone (AUC = 0.925, 95% CI: 0.897-0.954, and sensitivity and specificity of 79.60% and 93.60%, respectively).
CONCLUSION
RDW, NLR, and HRR can be utilized as simple and effective biomarkers for the diagnosis and evaluation of NSCLC progression.
背景
肺癌是全球癌症相关死亡的主要原因，非小细胞肺癌 (NSCLC) 占所有肺癌病例的 85%。炎症已被证明是恶性肿瘤的特征之一。肿瘤微环境中细胞因子介导的慢性炎症反应是肿瘤发生的重要因素。本研究旨在观察和评估红细胞分布宽度 (RDW)、中性粒细胞与淋巴细胞比值 (NLR) 和血红蛋白与红细胞分布宽度比值 (HRR) 在 NSCLC 进展中的价值。
方法
本研究共纳入 245 例 NSCLC 患者、97 例良性肺结节患者和 94 名健康志愿者。对年龄、性别、吸烟史、组织学类型、淋巴结转移、远处转移、TNM 分期和分化程度等因素进行统计学分析。分析 NSCLC 患者 RDW、NLR 和 HRR 与其他临床实验参数的相关性。然后，评估 RDW、NLR 和 HRR 在 NSCLC 进展中的诊断价值。
结果
RDW、NLR 和 HRR 可用于区分 NSCLC 患者与健康对照者（p<0.05）。此外，仅 III-IV 期 NSCLC 组的 RDW 与良性肺结节组有显著差异（p=0.033），而 NLR 和 HRR 可显著区分 NSCLC 患者与良性肺结节患者（p<0.001）。RDW 和 NLR 与 NSCLC 分期呈正相关，而 HRR 与 NSCLC 分期呈负相关。RDW、NLR 和 HRR 与 NSCLC 的分化程度也有显著相关性（p<0.05）。ROC 曲线分析表明，RDW 与 NLR、HRR 和 CEA 联合检测的诊断价值明显高于任一标志物单独检测（AUC=0.925，95%CI：0.897-0.954，灵敏度和特异度分别为 79.60%和 93.60%）。
结论
RDW、NLR 和 HRR 可作为诊断和评估 NSCLC 进展的简单而有效的生物标志物。
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