中性粒细胞与淋巴细胞比值及血小板与淋巴细胞比值在鉴别肺癌患者与健康受试者中的应用。
Neutrophil-to-Lymphocyte Ratio and Platelet-to-Lymphocyte Ratio in Blood to Distinguish Lung Cancer Patients from Healthy Subjects.
机构信息
Department of Clinical Laboratory, Wuxi People's Hospital Affiliated with Nanjing Medical University, Wuxi, 214023 Jiangsu Province, China.
Department of Pharmacy, Wuxi People's Hospital Affiliated with Nanjing Medical University, Wuxi, 214023 Jiangsu Province, China.
出版信息
Dis Markers. 2020 Oct 16;2020:8844698. doi: 10.1155/2020/8844698. eCollection 2020.
OBJECTIVE
Inflammation-driven markers play a crucial role in tumorigenesis and tumor progression. The neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) in blood are systemic inflammatory response markers. Some reports have showed that NLR and PLR are related to a poor prognosis in patients with lung cancer. However, little studies have reported whether NLR and PLR can be diagnostic markers for lung cancer. The aim of the current study is to investigate the roles of NLR and PLR in diagnosing lung cancer.
METHODS
This study analyzed data from lung cancer patients and healthy individuals in Wuxi People's Hospital Affiliated with Nanjing Medical University. The Mann-Whitney test was performed to compare differences between the lung cancer group and the control group. Based on white blood cell (WBC) counts, both lung cancer patients and healthy individuals were divided into the low-level group, moderate-level group, and high-level group. The Kruskal-Wallis test was applied to compare differences of NLR and PLR among those groups with different WBC counts. Spearman correlation analysis was used to assess correlations. Receiver operating characteristic (ROC) curves were performed to determine diagnostic accuracy.
RESULTS
210 patients diagnosed with lung cancer and 261 healthy subjects were enrolled in this study. Levels of NLR and PLR increased in the lung cancer group compared with the control group ( < 0.001). For the lung cancer group, NLR levels could rise with the increasing of WBC levels ( < 0.001) while PLR levels had no significant variation with the increasing of WBC levels ( = 0.206). For the control group, NLR levels could rise with the increasing of WBC levels ( < 0.001) while PLR levels would decline with the increasing of WBC levels ( < 0.001). In the lung cancer group, both NLR and PLR had no significant correlations with aspartate transaminase, urea, and glucose. The area under the curve (AUC) with 95% confidence interval (95% CI) of NLR and PLR to distinguish lung cancer patients from healthy subjects was, respectively, 0.684 (0.634-0.735) and 0.623 (0.571-0.674). When NLR and PLR were combined, AUC (95% CI) increased to 0.691 (0.642-0.740).
CONCLUSIONS
NLR and PLR alone have moderate ability to distinguish lung cancer patients from healthy subjects. Furthermore, combination forms of NLR and PLR can improve diagnostic ability.
目的
炎症驱动的标志物在肿瘤发生和肿瘤进展中起着关键作用。血液中的中性粒细胞与淋巴细胞比值（NLR）和血小板与淋巴细胞比值（PLR）是全身炎症反应的标志物。一些报道表明，NLR 和 PLR 与肺癌患者的预后不良有关。然而，很少有研究报道 NLR 和 PLR 是否可以作为肺癌的诊断标志物。本研究旨在探讨 NLR 和 PLR 在诊断肺癌中的作用。
方法
本研究分析了南京医科大学附属无锡人民医院肺癌患者和健康个体的数据。采用 Mann-Whitney 检验比较肺癌组和对照组之间的差异。根据白细胞（WBC）计数，将肺癌患者和健康个体分为低水平组、中水平组和高水平组。采用 Kruskal-Wallis 检验比较不同 WBC 计数组之间 NLR 和 PLR 的差异。采用 Spearman 相关分析评估相关性。绘制受试者工作特征（ROC）曲线以确定诊断准确性。
结果
本研究纳入了 210 例肺癌患者和 261 名健康受试者。与对照组相比，肺癌组 NLR 和 PLR 水平升高（<0.001）。对于肺癌组，NLR 水平随着 WBC 水平的升高而升高（<0.001），而 PLR 水平与 WBC 水平的升高无显著变化（=0.206）。对于对照组，NLR 水平随着 WBC 水平的升高而升高（<0.001），而 PLR 水平随着 WBC 水平的升高而降低（<0.001）。在肺癌组中，NLR 和 PLR 与天冬氨酸转氨酶、尿素和葡萄糖均无显著相关性。NLR 和 PLR 区分肺癌患者和健康受试者的曲线下面积（AUC）及其 95%置信区间（95%CI）分别为 0.684（0.634-0.735）和 0.623（0.571-0.674）。当 NLR 和 PLR 联合使用时，AUC（95%CI）增加至 0.691（0.642-0.740）。
结论
NLR 和 PLR 单独用于区分肺癌患者和健康受试者具有中等能力。此外，NLR 和 PLR 的联合形式可以提高诊断能力。
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