betway必威登陆网址 (betway.com )学报››2021,Vol. 42››Issue (9): 675-679.DOI:10.3969/j.issn.2097-0005.2021.09.008
房忠卫1(), 周宪伟1, 曹志强1, 宋艳芳2, 任更朴1
收稿日期:
2021-02-18出版日期:
2021-09-25发布日期:
2021-10-13作者简介:
房忠卫, 硕士, 主管技师, 研究方向:临检与肿瘤, E-mail:fangzhw110@163.com。Zhongwei Fang1(), Xianwei Zhou1, Zhiqiang Cao1, Yanfang Song2, Gengpu Ren1
Received:
2021-02-18Online:
2021-09-25Published:
2021-10-13摘要:
探讨外周血中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)以及系统性免疫性炎症指数(SII)在健康人群,甲状腺良性、恶性结节间的鉴别诊断价值。
选取2017年1月至2019年10月在聊城市第二人民医院确诊的172例甲状腺良性结节及285例恶性结节患者作为研究对象,选取同期该院健康查体199例患者作为对照组,记录术前外周血中性粒细胞计数、淋巴细胞计数以及血小板计数,并计算NLR、PLR、SII,用t检验比较NLR、PLR、SII在健康人群组、良性结节组、恶性结节组间的差异,用受试者工作特征曲线(ROC曲线)确定NLR、PLR、SII在不同组别中鉴别的临界值。
除NLR和SII在良恶性结节组比较中差异无统计学意义外,三项指标(NLR、PLR、SII)在其他三组两两比较中,差异均具有统计学意义(P < 0.05)。AUC面积在0.72~0.8之间。NLR、PLR、SII检测在健康人群与良性甲状腺结节人群鉴别中灵敏度分别为85.9%,92.5%,81.9%,在健康人群与甲状腺恶性结节组鉴别中灵敏度分别为70.4%,81.9%,74.1%,在良性结节组与恶性结节组的鉴别特异度分别为85.6%、69.5%,83.2%,差异具有统计学意义。
NLR、PLR、SII检测对健康人群与良性结节组以及健康人群与甲状腺结节组具有一定的鉴别价值,对良性结节与恶性结节的鉴别意义不明显。
中图分类号:
房忠卫, 周宪伟, 曹志强, 宋艳芳, 任更朴. 外周血NLR、PLR、SII在甲状腺结节中的诊断价值[J]. betway必威登陆网址 (betway.com )学报, 2021, 42(9): 675-679.
Zhongwei Fang, Xianwei Zhou, Zhiqiang Cao, Yanfang Song, Gengpu Ren. The diagnostic value of peripheral blood NLR, PLR and SII in thyroid nodules[J]. Journal of Shandong First Medical Unversity & Shandong Academy of Medical Sciences, 2021, 42(9): 675-679.
分组 | 总数(n) | 性别(男/女) | 年龄(岁) | NLR | PLR | SII |
---|---|---|---|---|---|---|
良性结节组(A组) | 172 | 23/149 | 50.03 ± 13.10 | 2.46 ± 1.47 | 150.98 ± 52.7 | 577.22 ± 344.96 |
恶性结节组(B组) | 285 | 56/229 | 48.75 ± 12.39 | 2.11 ± 0.94 | 147.28 ± 50.83 | 525.02 ± 262.29 |
健康对照组(C组) | 199 | 40/159 | 51.29 ± 14.05 | 1.54 ± 0.63 | 102.81 ± 30.21 | 339.09 ± 162.07 |
整体比较 | ||||||
χ2/t | 3.585 | 2.230 | 38.030 | 68.856 | 44.543 | |
P | 0.167 | 0.108 | < 0.001 | < 0.001 | < 0.001 | |
多重比较(P) | ||||||
A vs B | 0.016 | 0.843 | 0.243 | |||
A vs C | < 0.001 | < 0.001 | < 0.001 | |||
B vs C | < 0.001 | < 0.001 | < 0.001 |
表1基础资料
分组 | 总数(n) | 性别(男/女) | 年龄(岁) | NLR | PLR | SII |
---|---|---|---|---|---|---|
良性结节组(A组) | 172 | 23/149 | 50.03 ± 13.10 | 2.46 ± 1.47 | 150.98 ± 52.7 | 577.22 ± 344.96 |
恶性结节组(B组) | 285 | 56/229 | 48.75 ± 12.39 | 2.11 ± 0.94 | 147.28 ± 50.83 | 525.02 ± 262.29 |
健康对照组(C组) | 199 | 40/159 | 51.29 ± 14.05 | 1.54 ± 0.63 | 102.81 ± 30.21 | 339.09 ± 162.07 |
整体比较 | ||||||
χ2/t | 3.585 | 2.230 | 38.030 | 68.856 | 44.543 | |
P | 0.167 | 0.108 | < 0.001 | < 0.001 | < 0.001 | |
多重比较(P) | ||||||
A vs B | 0.016 | 0.843 | 0.243 | |||
A vs C | < 0.001 | < 0.001 | < 0.001 | |||
B vs C | < 0.001 | < 0.001 | < 0.001 |
分组 | AUC线下面积 | 95%CI | 最大约登指数 | cut-off值 | 灵敏度(%) | 特异度(%) | 阴性预测值(%) | 阳性预测值(%) |
---|---|---|---|---|---|---|---|---|
NLR | 0.738 | 0.687~0.788 | 0.353 | 2.065 | 85.92 | 49.43 | 80.33 | 59.437 |
PLR | 0.782 | 0.735~0.829 | 0.442 | 145.560 | 92.54 | 51.75 | 88.79 | 62.350 |
SII | 0.756 | 0.707~0.806 | 0.424 | 443.030 | 81.91 | 60.51 | 79.47 | 64.090 |
表2NLR、PLR、SII在最大约登指数时对鉴别健康人群和良性甲状腺结节的诊断效度
分组 | AUC线下面积 | 95%CI | 最大约登指数 | cut-off值 | 灵敏度(%) | 特异度(%) | 阴性预测值(%) | 阳性预测值(%) |
---|---|---|---|---|---|---|---|---|
NLR | 0.738 | 0.687~0.788 | 0.353 | 2.065 | 85.92 | 49.43 | 80.33 | 59.437 |
PLR | 0.782 | 0.735~0.829 | 0.442 | 145.560 | 92.54 | 51.75 | 88.79 | 62.350 |
SII | 0.756 | 0.707~0.806 | 0.424 | 443.030 | 81.91 | 60.51 | 79.47 | 64.090 |
分组 | AUC线下面积 | 95%CI | 最大约登指数 | cut-off值 | 灵敏度(%) | 特异度(%) | 阴性预测值(%) | 阳性预测值(%) |
---|---|---|---|---|---|---|---|---|
NLR | 0.553 | 0.497~0.608 | 0.120 | 2.990 | 27.32 | 85.63 | 41.53 | 75.73 |
PLR | 0.532 | 0.477~0.588 | 0.130 | 159.250 | 43.61 | 69.52 | 42.71 | 70.45 |
SII | 0.535 | 0.479~0.590 | 0.087 | 715.780 | 25.64 | 83.27 | 40.28 | 71.57 |
表3NLR、PLR、SII在最大约登指数时对鉴别良性、恶性甲状腺结节的诊断效度
分组 | AUC线下面积 | 95%CI | 最大约登指数 | cut-off值 | 灵敏度(%) | 特异度(%) | 阴性预测值(%) | 阳性预测值(%) |
---|---|---|---|---|---|---|---|---|
NLR | 0.553 | 0.497~0.608 | 0.120 | 2.990 | 27.32 | 85.63 | 41.53 | 75.73 |
PLR | 0.532 | 0.477~0.588 | 0.130 | 159.250 | 43.61 | 69.52 | 42.71 | 70.45 |
SII | 0.535 | 0.479~0.590 | 0.087 | 715.780 | 25.64 | 83.27 | 40.28 | 71.57 |
分组 | AUC线下面积 | 95%CI | 最大约登指数 | cut-off值 | 灵敏度(%) | 特异度(%) | 阴性预测值(%) | 阳性预测值(%) |
---|---|---|---|---|---|---|---|---|
NLR | 0.722 | 0.681~0.763 | 0.325 | 1.725 | 70.43 | 62.13 | 47.88 | 81.11 |
PLR | 0.799 | 0.743~0.815 | 0.419 | 127.640 | 81.94 | 60.00 | 58.91 | 82.38 |
SII | 0.748 | 0.709~0.788 | 0.388 | 385.975 | 74.15 | 67.43 | 53.17 | 83.91 |
表4NLR、PLR、SII在最大约登指数时对鉴别健康人群和甲状腺结节的诊断效度
分组 | AUC线下面积 | 95%CI | 最大约登指数 | cut-off值 | 灵敏度(%) | 特异度(%) | 阴性预测值(%) | 阳性预测值(%) |
---|---|---|---|---|---|---|---|---|
NLR | 0.722 | 0.681~0.763 | 0.325 | 1.725 | 70.43 | 62.13 | 47.88 | 81.11 |
PLR | 0.799 | 0.743~0.815 | 0.419 | 127.640 | 81.94 | 60.00 | 58.91 | 82.38 |
SII | 0.748 | 0.709~0.788 | 0.388 | 385.975 | 74.15 | 67.43 | 53.17 | 83.91 |
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