| 高飞,刘素坤,刘文.外周血中性粒细胞与淋巴细胞比值联合癌胚抗原检测对局部晚期宫颈癌同步放化疗效果的预测价值[J].安徽医药,2025,29(2):294-298. |
| 外周血中性粒细胞与淋巴细胞比值联合癌胚抗原检测对局部晚期宫颈癌同步放化疗效果的预测价值 |
| Predictive analysis of combined detection of neutrophil to lymphocyte ratio and carcinoembryonic antigen expression in peripheral blood for the effect of concurrent radiotherapy and chemotherapy in locally advanced cervical cancer |
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| DOI：10.3969/j.issn.1009-6469.2025.02.016 |
| 中文关键词: 宫颈肿瘤 同步放化疗 中性粒细胞与淋巴细胞比值 癌胚抗原 预测价值 |
| 英文关键词: Uterine cervical neoplasms Synchronous radiochemotherapy Neutrophil to lymphocyte ratio Carcinoembryonic an-tigen Predictive value |
| 基金项目:保定市科技计划项目( 2241ZF236) |
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| 中文摘要: |
| 目的探究外周血中性粒细胞与淋巴细胞比值( NLR)和癌胚抗原( CEA)表达联合检测对局部晚期宫颈癌( LACC)同步放化疗效果的预测价值。方法选取 2021年 1―12月就诊于保定市第一中心医院的 120例 LACC病人为研究对象。根据 120例 LACC病人同步放化疗效果分为 A组［完全缓解(CR)/部分缓解(PR)n=94］和 B组［病情稳定(SD)/病情进展( PD)n=26］较两组治疗前外周血 NLR、CEA和鳞状细胞癌相关抗原(SCC-Ag)表达水平，。多元logistic回归分析影响LACC病人同步，放化，疗比效果的因素；受试者操作特征曲线(ROC曲线)分析外周血 NLR和 CEA表达水平对 LACC病人同步放化疗效果的预测价值。结与 B组比较， A组 NLR(2.51±0.24比 2.97±0.36)、 CEA［( 6.84±0.92)μg/L比( 8.77±1.03)μg/L］、 SCC-Ag［( 5.98±1.19)μg/L比(9果.06±1.65)μg/L］表达水平明显较低( P<0.05)； logistic回归分析结果显示， NLR高表达、 CEA高表达、 SCC-Ag高表达、淋巴结阳性、非鳞癌、 FIGO分期高是影响 LACC病人同步放化疗效果的独立危险因素( P<0.05)。 ROC结果显示， NLR单独预测 LACC病人同步放化疗效果的 AUC为 0.81，95%CI:(0.73，0.87)，灵敏度、特异度分别为 69.23%、86.17%，最佳截断值为 2.96；CEA水平单独预测 LACC病人同步放化疗效果的 AUC为 0.86，95%CI:(0.79，0.92)灵敏度、特异度分别为 73.08%、85.11%，最佳截断值为 8.06 μg/L；SCC-Ag水平单独预测 LACC病人同步放化疗效果的 AUC0.88，95%CI:(0.80，0.95)，灵敏度、特异度分别为 为，69.23%、85.11%，最佳截断值为 8.28 μg/L；三者联合预测 LACC病人同步放化疗效果的 AUC(0.94)显著大于 NLR单独预测的(Z=2.61，P=0.009)、 CEA单独预测的 AUC(Z=2.57，P=0.010)和 SCC-Ag单独预测的 AUC(Z=1.99，P=0.046)。结论 NLR和 CEA在 LACC同步放化疗有效病人中水平较低，二者联合检测对 LACC同步放化疗效果具有较高的预测价值。 |
| 英文摘要: |
| Objective To explore the predictive value of combined detection of neutrophil to lymphocyte ratio (NLR) and carcinoem-bryonic antigen (CEA) expression in peripheral blood for the effect of concurrent radiotherapy and chemotherapy in locally advancedcervical cancer (LACC).Methods A total of 120 LACC patients who visited Baoding First Central Hospital from January to December2021 were regarded as the study subjects. The 120 LACC patients were grouped into effective group [complete response (CR)/partial re-sponse (PR),n=94] and ineffective group [stable disease(SD)/progressive disease(PD),n=26] according to the effect of concurrent radio-therapy and chemotherapy, the expression levels of NLR, CEA and squamous cell carcinoma associated antigen (SCC-Ag) in peripheralblood of the two groups were compared before treatment. Multivariate logistic regression analysis was applied to analyze the factors af-fecting the effect of concurrent radiotherapy and chemotherapy in LACC patients; the predictive value of the expression levels of NLRand CEA in peripheral blood for the effect of concurrent radiotherapy and chemotherapy in LACC patients was analyzed by the ROCcurve.Results Compared with group B, the expression levels of NLR (2.51±0.24 vs. 2.97±0.36), CEA [(6.84 ±0.92) μg/L vs. (8.77± 1.03) μg/L] and SCC-Ag [(5.98±1.19) μg/L vs. (9.06±1.65) μg/L] in group A were significantly lower (P<0.05). Logistic regression anal-ysis showed that high expression of NLR, CEA, SCC-Ag, positive lymph nodes, non-squamous cell carcinoma and high FIGO stage wereindependent risk factors affecting the effect of concurrent chemoraotherapy in LACC patients (P<0.05). The ROC results showed thatthe AUC of NLR alone predicting the effect of concurrent radiotherapy and chemotherapy in LACC patients was 0.81, 95%CI:(0.73, 0.87), its sensitivity and specificity were 69.23% and 86.17%, respectively, and the best cut-off value was 2.96; the AUC of CEA alone predicting the effect of concurrent radiotherapy and chemotherapy in LACC patients was 0.86, 95%CI: (0.79, 0.92), its sensitivity and specificity were 73.08% and 85.11%, respectively, and the best cut-off value was 8.06 μg/L; The AUC of SCC-Ag level alone in predict-ing the effect of concurrent chemoradiotherapy in LACC patients was 0.88, 95%CI: (0.80, 0.95), the sensitivity and specificity were 69.23% and 85.11%, respectively, and the optimal cut-off value was 8.28 μg/L; The AUC (0.94) predicted by the combination of thethree methods was significantly greater than that predicted by NLR alone (Z=2.61, P=0.009), CEA alone (Z=2.57, P=0.010) and SCC-Ag alone (Z=1.99, P=0.046).Conclusion The levels of NLR and CEA in LACC patients with effective synchronous radiochemothera-py are low, the combined detection of the two has a high predictive value for the effect of LACC concurrent radiotherapy and chemother-apy. |
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