The Diagnostic Significance Of Systemic Inflammatory Indicators For Early Cervical Cancer

Objective:To investigate the diagnostic significance of neutrophil to lymphocyte ratio(NLR),platelet to lymphocyte ratio(PLR),lymphocyte to monocyte ratio(LMR)and red blood cell distribution width(RDW)in patients with early cervical cancer.Methods:From January 2010 to November 2018,135 patients(cervical cancer group)who were hospitalized in our hospital for early cervical cancer surgery and 96 healthy women(healthy control group)were collected.We made the blood test of healthy group and cervical cancer group before operation.The neutrophil count,lymphocyte count,platelet count,monocyte count were recorded,and the NLR,PLR and LMR values were calculated.RDW-SD and RDW-CV values were recorded.The age of patients and admission diagnosis were recorded.The classification of cervical cancer,lymph node metastasis and differentiation degree were recorded according to pathological reports.We analyzed the difference of inflairanatory indicators between cervical cancer group and healthy group with the ROC curve,and determined the most meaningful cut-off value of indicators,then divided into two groups,high and low according to cut-off value.After comparing the systemic inflammatory indexes of each group,we determined the significance of systemic inflammnation indicators for patients with early cervical cancer to provide reference for the diagnosis of early cervical cancer.Result:(1)Comparing the age of the health group with the age of the cervical cancer group,P>0.05.(2)Comparing the NLR,LMR and RDW-CV values of healthy group with cervical cancer group,the NLR and RDW-CV values of cervical cancer group increased significantly,while the LMR values decreased significantly(P<0.05),and the PLR and RDW-SD values did not change significantly(P>0.05).(3)There was no significant difference in lymph node metastasis and differentiation between cervical cancer patients and NLR,PLR,LMR,RDW-SD.RDW-CV values(P>0.05).(4)There was no significant difference in NLR,PLR,RDW-SD and RDW-CV values between cervical squamous cell carcinoma and cervical adenocarcinoma(P>0.05),while LMR values might be used as a marker for differentiating cervical squamous cell carcinoma from cervical adenocarcinoma(P<0.05).(5)ROC curve analysis showed that the area under the line of NLR was 0.654,P<0.001,95%CI was 0.584-0.732,NLR truncated value was 1.985,LMR was 0.572,P>0.05,95%CI was 0.499-0.646,RDW-CV was 0.628,P<0.05,95%CI was 0.544-0.702,RDW-CV truncated value was 12.050.According to the ROC curve,the proportion of low NLR values in the healthy group was higher,and the proportion of high RDW-CV values in the cervical cancer group was higher.(6)According to ROC curve,the sensitivity and specificity of NLR were 0.452 and 0.885.Because LMR has no statistical significance,the truncation value and sensitivity and specificity of RDW-CV were not calculated.The sensitivity and specificity of RDW-CV were 0.904 and 0.406.Conclusion:(1)NLR values have low misdiagnosis rate for early diagnosis of cervical cancer;RDW-CV values have low missed diagnosis rate;NLR and RDW-CV values can be used as cheap and convenient new laboratory indicators for early diagnosis of cervical cancer patients.(2)Perioperative peripheral blood LMR can be used as an indicator to distinguish cervical squamous and adenocarcinoma.