| Objective:In this study,the clinical value of peripheral blood neutrophil/lymphocyte ratio(NLR),platelet/lymphocyte ratio(PLR)and tumor markers CEA,CA125 and NSE in clinical staging of lung cancer were investigated by combined detection.Methods:This study retrospectively collected clinical data of lung cancer patients diagnosed by cytopathology and without any treatment in the department of respiratory and oncology,the first affiliated hospital of nanchang university,who visited the hospital on January 1,2014,solstice,and January 1,2018.Clinical data of the patients were collected,including age,gender,smoking history and histopathological type of the patients.Laboratory and imaging data: before treatment,peripheral blood neutrophils count,peripheral blood lymphocytes count,peripheral blood platelet count,serum tumor markers CEA,CA125,NSE,chest CT(plain scan+ enhancement),abdominal ultrasound or CT,head CT or MRI,and whole-body bone scan.According to the imaging data of the patients,clinical staging was conducted according to the 8th edition of international TNM staging standard for lung cancer.Use statistical methods to compare different stage lung cancer patients with peripheral blood NLR,PLR and the difference of serum tumor markers,using correlation analysis of peripheral blood NLR,PLR and study the correlation of clinical features,and calculate the peripheral blood NLR,PLR,CEA,CA125,NSE separately used to diagnose Ⅳ period the cutoff value of lung cancer,explored five unite the Ⅳ period clinical value in diagnosis of lung cancer.Results:(1)There was no difference in the general data of 300 lung cancer patients in this study in terms of gender,age,smoking history and histological and pathological types between different stages of lung cancer(P > 0.05).(2)Correlation analysis showed that peripheral blood NLR and PLR levels werecorrelated with clinical stages T,N and M.Patients with high levels of NLR and PLR were more likely to develop in advanced lung cancer and multiple metastases.(3)Ⅰ ~ Ⅲ period lung cancer patients with peripheral blood NLR,PLR,CEA,CA125,NSE levels and Ⅳ period lung cancer group have significant differences.NLR,PLR,CEA,CA125,NSE median in Ⅳ period lung cancer group were 3.73,204.42 and 13.63 ng/ml,56.88 U/ml,29.76 ng/ml.In Ⅰ~Ⅲ period lung cancer group were 2.41,152.55 and 4.37 ng/ml,18.70 U/ml,16.57 ng/ml.(4)Using ROC curve analysis of each single index against Ⅳ period lung cancer diagnosis about their cut-off point of maximum CEA 8.74 ng/ml,respectively,CA125 24.62 U/ml,NSE 21.21 ng/ml,PLR 185.21,NLR2.76,diagnostic sensitivity of CA125 respectively > NLR > PLR > NSE > the CEA,the corresponding values were 88.00%,85.33%,81.33%,80.00%,73.33%;The diagnostic specificity was CEA > CA125 = NSE > PLR = NLR,and the corresponding values were 89.33%,76.67%,76.67%,72.67% and 72.67%,respectively.(5)Using ROC curve analysis of the combination of the different indicators Ⅳperiod lung cancer diagnosis value in CEA + NSE + CA125 + PLR + NLR sensitivity is highest,at 91.70%,specificity of 80.30%,the sensitivity of a single index is increase.Conclusion:(1)Peripheral blood NLR and PLR levels in patients with lung cancer were correlated with T stage,N stage and M stage.(2)Ⅳ period lung cancer patients,NLR、PLR and serum tumor markers CEA,CA125,NSE level is relatively high Ⅰ ~ Ⅲ period lung cancer patients;Detection of peripheral blood NLR and PLR combined with serum tumor markers CEA,CA125 and NSE has certain clinical value in clinical staging and prognosis evaluation of lung cancer. |
