Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan;
Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
Anticancer Res. 2023 Jul;43(7):3349-3357. doi: 10.21873/anticanres.16511.
BACKGROUND/AIM: Soft-tissue tumors are difficult to differentiate as benign or malignant. Immune markers, such as the neutrophil-lymphocyte ratio (NLR), monocyte-lymphocyte ratio (MLR), platelet-lymphocyte ratio (PLR), and absolute lymphocyte count (ALC) in serum, have been reported to be useful in the diagnosis and predicting prognosis of several malignancies. We investigated the diagnostic value of these immune markers in differentiating soft-tissue tumors.
A total of 692 patients who underwent biopsy or surgery of soft-tissue tumors were included and divided into benign tumor, low-grade malignancy, or high-grade malignancy groups. Immune markers were calculated from the preoperative blood tests and compared between the groups. A receiver operating curve (ROC) analysis was conducted between the benign disease group and a combination of the groups with malignancy to determine which immune marker had the most diagnostic value.
NLR and MLR were significantly different between the three groups with benign disease having the lowest value and high-grade malignancies the highest. Benign disease was also associated with lower PLR and higher ALC. There was no difference between the low- and high-grade malignancies in PLR and ALC. From the ROC analysis, NLR had the highest area under the curve (AUC) value of 0.773 out of the four markers. When limited to small tumors (≤30 mm), NLR had the highest AUC value of 0.729.
The NLR showed the highest diagnostic value, although the diagnostic ability was not adequately high to differentiate benign and malignant soft-tissue tumors alone. NLR may serve as diagnostic support in combination with clinical history, physical findings, and tumor-imaging results.
背景/目的：软组织肿瘤的良恶性鉴别存在困难。中性粒细胞-淋巴细胞比值（NLR）、单核细胞-淋巴细胞比值（MLR）、血小板-淋巴细胞比值（PLR）和血清中绝对淋巴细胞计数（ALC）等免疫标志物已被报道可用于多种恶性肿瘤的诊断和预后预测。我们研究了这些免疫标志物在鉴别软组织肿瘤中的诊断价值。
共纳入 692 例行软组织肿瘤活检或手术的患者，并分为良性肿瘤、低级别恶性肿瘤或高级别恶性肿瘤组。从术前血液检查中计算免疫标志物，并比较各组之间的差异。在良性疾病组与恶性肿瘤组的组合之间进行接受者操作特征曲线（ROC）分析，以确定哪种免疫标志物具有最高的诊断价值。
NLR 和 MLR 在三组之间存在显著差异，良性疾病组的 NLR 和 MLR 值最低，高级别恶性肿瘤组的 NLR 和 MLR 值最高。良性疾病还与较低的 PLR 和较高的 ALC 相关。低级别和高级别恶性肿瘤之间的 PLR 和 ALC 无差异。从 ROC 分析来看，NLR 的四项标志物中 AUC 值最高，为 0.773。当限制在小肿瘤（≤30mm）时，NLR 的 AUC 值最高，为 0.729。
尽管 NLR 单独区分良恶性软组织肿瘤的诊断能力不够高，但 NLR 显示出最高的诊断价值。NLR 可以与临床病史、体格检查和肿瘤影像学结果相结合，作为诊断支持。
