Senior Department of Obstetrics & Gynecology, the Seventh Medical Center of PLA General Hospital, Beijing, China.
BMC Cancer. 2024 Jun 28;24(1):780. doi: 10.1186/s12885-024-12561-7.
Exploring the predictive value of NLR, PLR, MLR, and SII for the severity of cervical cancer screening abnormalities in patients.
A retrospective analysis was conducted on the data of 324 patients suspected of cervical lesions due to abnormal TCT and/or HPV in our hospital from January 2023 to December 2023, who underwent colposcopy. The pathological results of colposcopic biopsy confirmed that there were 140 cases of chronic cervicitis, which classified as the group without cervical lesions. The cervical lesion group included 184 cases, including 91 cases of LSIL, 71 cases of HSIL, and 22 cases of cervical cancer. Compared the differences in preoperative peripheral blood NLR, PLR, MLR, and SII among different groups of patients, and evaluated their predictive value for the severity of cervical lesions using Receiver Operating Characteristic (ROC) curves.
The levels of NLR, PLR, and SII in the group without cervical lesions were lower than those in the group with cervical lesions (p < 0.05), and there was no statistically significant difference in MLR (p > 0.05). The comparison of NLR among LSIL, HSIL, and cervical cancer groups showed statistically significant differences (p < 0.05), while PLR, MLR, and SII showed no statistically significant differences (p > 0.05). The AUC of peripheral blood NLR, PLR, and SII for predicting cervical lesions were 0.569, 0.582, and 0.572, respectively. The optimal cutoff values were 2.3,176.48, and 603.56. The sensitivity and specificity were 38.6% and 73.6%, 28.8% and 85.7%, 37.5% and 76.4%, respectively. At the same time, the joint testing of the three had the highest efficiency, with sensitivity of 69% and specificity of 45%.
Although the peripheral blood NLR, PLR, and SII of the cervical lesions patients were higher than those without cervical lesions in cervical cancer screening abnormal patients, the predictive ROC curve discrimination was low. Therefore, it is not recommended to use preoperative peripheral blood inflammatory markers as markers for cervical cancer screening abnormal patient diversion.
探讨 NLR、PLR、MLR 和 SII 对宫颈癌筛查异常患者严重程度的预测价值。
对 2023 年 1 月至 12 月我院因 TCT 和/或 HPV 异常怀疑宫颈病变的 324 例患者进行回顾性分析,行阴道镜检查,阴道镜活检病理结果证实慢性宫颈炎 140 例为无宫颈病变组,宫颈病变组 184 例,其中低度鳞状上皮内病变(LSIL)91 例,高度鳞状上皮内病变(HSIL)71 例,宫颈癌 22 例。比较不同组别患者术前外周血 NLR、PLR、MLR 和 SII 的差异,采用受试者工作特征(ROC)曲线评估其对宫颈病变严重程度的预测价值。
无宫颈病变组 NLR、PLR 和 SII 水平低于宫颈病变组(p<0.05),而 MLR 无统计学差异(p>0.05)。LSIL、HSIL 和宫颈癌组 NLR 比较差异有统计学意义(p<0.05),PLR、MLR 和 SII 无统计学差异(p>0.05)。外周血 NLR、PLR 和 SII 预测宫颈病变的 AUC 分别为 0.569、0.582 和 0.572,最佳截断值分别为 2.3、176.48 和 603.56,灵敏度分别为 38.6%和 73.6%,特异性分别为 28.8%和 85.7%,37.5%和 76.4%。同时,三者联合检测效率最高,灵敏度为 69%,特异性为 45%。
宫颈癌筛查异常患者中,外周血 NLR、PLR 和 SII 高于无宫颈病变患者,但预测 ROC 曲线的区分度较低,因此不建议将术前外周血炎症标志物作为宫颈癌筛查异常患者分流的标志物。