| Objective: To investigate the clinical value of neutrophil lymphocyte ratio combined with squamous cell carcinoma antigen in the diagnosis of early lung squamous cell carcinoma in Qinghai province,and to provide a new method for the diagnosis of early lung squamous cell carcinoma.Methods: In this study,120 patients with early lung squamous cell carcinoma who were initially treated in the affiliated hospital of Qinghai University from September 2014 to March 2020(stage Ⅰ and stage Ⅱ)were collected as the experimental group,and 120 healthy patients who underwent physical examination in the affiliated hospital of Qinghai University during the same period were collected as the control group for retrospective study.Collect and organize all the lung squamous carcinoma patients and health needs improving per capita average data(age,gender,smoking),blood routine examination and tumor markers,the experimental group also need to improve the clinical stage and pathological subtype of lung squamous carcinoma,and the selection of the ratio of neutrophils and lymphocytes(Neutrophil to lymphocyte ratio,NLR)and squamous cell carcinoma antigen(squamous cell carcinoma antigen,SCC Ag)as indicators of observation.By applying receiver operating characteristic curve(ROC)to judge and analyze the sensitivity and specificity of NLR and SCC-Ag,as well as the value of NLR combined with SCC in the diagnosis of early lung squamous cell carcinoma.Results: In the experimental group,there were 120 cases,including 95 males and 25 females,with an average age of 60.08±8.45 years.In the control group,there were 84 males and 36 females,with an average age of 58.84±8.29 years.There was no statistical difference between the two groups in general data(P > 0.05).In the experimental group,83 were smokers and 37 were non-smokers.Control group smoking 19 cases,non-smoking 101 cases.The number of smoking cases in the experimental group was significantly higher than that in the control group(P < 0.05).Neutrophils(NE): 5.19±2.82×10~9/L,lymphocyte(LY): 1.69±0.61×10~9/L,NLR: 3.13±1.18,SCC-Ag: 3.84±1.31ng/ml.Control group NE: 3.70±0.70×10~9/L,LY:1.92±0.34×10~9/L,NLR: 2.58±1.18,SCC-Ag: 0.36±0.41ng/ml,the experimental group of NE,LY,NLR,SCC-Ag significantly higher than the control group(P < 0.05).ROC curve was used to analyze the Area under curve(AUC)of NLR in the diagnosis of early lung squamous cell carcinoma(AUC)0.683,95% confidence interval(CI)(0.62~0.75),the sensitivity was 0.59,and the specificity was 0.78.The AUC of SCC-Ag in the diagnosis of early lung squamous cell carcinoma was 0.716,95%CI(0.65~0.78),the sensitivity was 0.62,and the specificity was 0.77.The Area under the curve of the diagnosis of early lung squamous cell carcinoma by NLR combined with SCC-Ag was 0.791,95%CI(0.73~0.85),the sensitivity was 0.79,and the specificity was 0.80.The NLR combined with SCC-Ag was statistically significant in the diagnosis of early lung squamous cell carcinoma(P < 0.05).In the comparison between the experimental groups,NLR was 3.47±1.34 in 61 cases of non-keratinized lung squamous carcinoma and 3.28±0.94 in 59 cases of keratinized lung squamous carcinoma(P > 0.05),but higher than that in the control group.SCC-Ag of non-keratinized lung squamous carcinoma was 4.48±1.30,SCC-Ag of keratinized lung squamous carcinoma was 3.40±1.15,and SCC-Ag of non-keratinized lung squamous carcinoma was higher than that of keratinized lung squamous carcinoma(P < 0.05).NLR was 2.85±1.11,SCC-Ag was 3.52±1.10,and NLR was 3.32±1.19 and SCC-Ag was 4.06±1.40 in 71 patients with middle stage Ⅰ and middle stage II,respectively.The comparison results of NLR and SCC indexes in the experimental group were statistically significant(P < 0.05),and NLR and SCC were larger in stage Ⅱ than in stage Ⅰ.Conclusion:NLR and SCC-Ag alone have certain guiding significance in the diagnosis of early lung squamous cell carcinoma.Compared with a single index,NLR combined with SCC-Ag can improve the sensitivity,specificity and diagnostic accuracy in the diagnosis of squamous cell carcinoma. |
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