术前红细胞分布宽度与淋巴细胞数比值(RLR)、D-二聚体在甲状腺癌患者的临床价值分析

Analysis of the Clinical Value of Preoperative Erythrocyte Distribution Width to Lymphocyte Number Ratio (RLR) and D-dimer in Patients with Thyroid Cancer

摘要: 目的：探讨术前红细胞分布宽度与淋巴细胞数比值(Red blood cell distribution width and lymphocyte number ratio, RLR)、D-二聚体在甲状腺癌诊断中的价值。方法：回顾性收集2013年12月~2015年9月在广西医科大学附属肿瘤医院头颈外科收治的80例术后病理诊断为甲状腺良性疾病作为对照组和90例术后病理诊断为甲状腺癌患者作为观察组的临床资料，比较两组的一般资料、术前RLR、术前D-二聚体。运用受试者工作特征曲线(receiver operating characteristic curve, ROC)分析术前RLR、术前D-二聚体诊断甲状腺癌的临界值、灵敏度和特异度、阳性似然比(Positive likelihood ratio, +LR)、阴性似然比(negative likelihood ratio, −LR)、曲线下面积(area under ROC curve, AUC)；分析术前RLR、术前D-二聚体及术前RLR联合术前D-二聚体诊断甲状腺癌的临床价值。结果：观察组RLR和D-二聚体水平均较对照组显著升高，差异具有统计学意义(P < 0.05)；观察组患者中RLR、D-二聚体及RLR联合D-二聚体的阳性检出率明显高于对照组，差异具有统计学意义(P < 0.05)；RLR联合D-二聚体的AUC值高于RLR、D-二聚体。结论：RLR、D-二聚体在甲状腺癌的诊断中具有一定的价值，RLR联合D-二聚体有助于提高甲状腺癌诊断。

Abstract: Objective: To explore the value of preoperative red blood cell distribution width and lymphocyte number ratio (RLR) and D-dimer in the diagnosis of thyroid cancer. Methods: A retrospective collection of 80 patients with pathological diagnosis of benign thyroid disease after operation in the Head and Neck Surgery Department of the Affiliated Tumor Hospital of Guangxi Medical University from December 2013 to September 2015 as a control group and 90 patients with pathological diagnosis of thyroid cancer Observe the clinical data of the observation group and compare the general data, preoperative RLR, and preoperative D-dimer of the two groups. Receiver operating characteristic curve (ROC) was used to analyze the critical value, sensitivity and specificity, positive likelihood ratio (+LR) of preoperative RLR and preoperative D-dimer in the diagnosis of thyroid cancer), negative likelihood ratio (negative likelihood ratio, −LR), area under ROC curve (AUC); analysis of preoperative RLR, preoperative D-dimer, and preoperative RLR combined with preoperative D-dimer The clinical value of thyroid cancer diagnosis. Results: The levels of RLR and D-dimer in the observation group were significantly higher than those in the control group, the difference was statistically significant (P < 0.05); RLR, D-dimer and RLR combined with D-dimer in the observation group The positive detection rate was significantly higher than the control group, the difference was statistically significant (P < 0.05); the AUC value of RLR combined with D-dimer was higher than that of RLR and D-dimer. Conclusion: RLR and D-dimer have certain value in the diagnosis of thyroid cancer. RLR combined with D-dimer can help improve the diagnosis of thyroid cancer.