2018 年第 10 期 第 13 卷

外周血红细胞体积分布宽度和中性粒细胞计数与淋巴细胞计数比值对前列腺癌的诊断价值

Values of peripheral blood red blood cell volume distribution width and neutrophil-to-lymphocyte ratio in diagnosis of prostatic cancer

作者：张玥鞠瑛刘义庆董振芳张健王勇张炳昌

英文作者：

单位：250021济南，山东大学附属省立医院临床医学检验部

英文单位：

关键词：前列腺癌；红细胞体积分布宽度；中性粒细胞计数与淋巴细胞计数比值

英文关键词：

• 摘要：

• 【摘要】目的    分析外周血红细胞体积分布宽度（RDW）和中性粒细胞计数与淋巴细胞计数比值（NLR）对前列腺癌的诊断价值。方法    完全随机选取2012年1月至2016年12月在山东大学附属省立医院住院期间经临床和病理学诊断确诊的207例前列腺癌患者（前列腺癌组）及同期186例前列腺增生患者（前列腺增生组），对相关检查指标进行组间比较和分析。结果    前列腺癌组外周血RDW、总前列腺特异性抗原（TPSA）和游离前列腺特异性抗原（FPSA）高于前列腺增生组（均P＜0.01）。受试者工作特征曲线分析显示，RDW和NLR评估前列腺癌的曲线下面积分别为0.707和0.553，95%置信区间分别为0.656～0.759和0.496～0.610，RDW和NLR的最佳截点分别为12.650和4.305，敏感度分别为73.90%和20.40%，特异度分别为59.70%和91.30%。以12.650和4.305截点为界，将前列腺癌患者分为高RDW组（＞12.650%）和低RDW组（≤12.650%），高NLR组（＞4.305）和NLR低组（≤4.305）；高RDW组TPSA、FPSA水平和前列腺癌Gleason评分≥7分比例均高于低RDW组（均P＜0.05）。结论    外周血RDW水平显著升高可区分前列腺癌和前列腺增生，具有较高的敏感度和特异度，还可反映前列腺癌的恶性程度，此外NLR还可作为前列腺癌患者术后病情评估的指标。

• 【Abstract】Objective    To analyze the values of peripheral blood red blood cell volume distribution width(RDW) and neutrophil-to-lymphocyte ratio(NLR) in diagnosis of prostatic cancer. Methods    From January 2012 to December 2016, 207 cases of prostatic cancer and 186 cases of benign prostatic hyperplasia were randomly selected in Shandong Provincial Hospital Affiliated to Shandong University. Diagnostic indicators were analyzed using the receiver operating characteristic(ROC) curve. Results    Levels of RDW, total prostate specific antigen(TPSA) and free prostate specific antigen(FPSA) in prostatic cancer group were significantly higher than those in benign prostatic hyperplasia group（P＜0.01）. Area under ROC curve of RDW and NLR in diagnosis of prostatic cancer was 0.707 and 0.553; 95% confidence interval was 0.656-0.759 and 0.496-0.610; the best cutoff point was 12.650 and 4.305; the sensitivity was 73.90% and 20.40%; the specificity was 59.70% and 91.30%. The patients were divided into high RDW group(＞12.650%) and low RDW group(≤12.650%), high NLR group(＞4.305) and low NLR group(≤4.305). TPSA, FPSA and Gleason score in high RDW group were significantly higher than those in low RDW group（P＜0.05）. Conclusions    Elevated RDW level in peripheral blood is an indicator for the identification of prostatic cancer and benign prostatic hyperplasia with good sensitivity and specificity. RDW can also reflect the malignant degree of prostate cancer. NLR is an indicator for the postoperative evaluation of prostate cancer.