血清CA19-9联合外周血NLR、PLR、MLR、SII对肝外胆管癌的诊断价值

Diagnostic Value of Serum CA19-9 Combined with Peripheral Blood NLR, PLR, MLR and SII in Extrahepatic Cholangiocarcinoma

摘要: 目的：探讨CA19-9、中性粒细胞淋巴细胞比率(NLR)、血小板淋巴细胞比率(PLR)、单核细胞淋巴细胞比率(MLR)和全身免疫炎症指数(SII)在肝外胆管癌(ECC)中的诊断价值。方法：选取2012年1月~2021年9月青岛市市立医院收治的ECC患者150例作为ECC组及150例健康体检者作为对照组，对其CA19-9、NLR、PLR、MLR和SII进行检测分析。采用受试者工作特征(ROC)曲线分析各指标单独和联合检测诊断ECC的效能。结果：ECC组CA19-9、NLR、PLR、MLR、SII的水平均高于对照组(P < 0.05)。ROC曲线分析显示，CA19-9、NLR、PLR、MLR、SII诊断ECC所对应的AUC值分别为0.899、0.869、0.857、0.796、0.884，四项炎症指标诊断敏感性分别为68.70%、74.00%、72.70%、79.30%，特异性分别为94.00%、84.00%、76.00%、87.30%，CA19-9联合四项炎症指标进行诊断的AUC值为0.975，敏感性和特异性为92.00%和96.70%。结论：CA19-9、NLR、PLR、MLR、SII在ECC患者中升高，对于ECC的诊断有一定价值，联合诊断相比于单个指标具有更高的诊断效能。

Abstract: Objective: To investigate the diagnostic value of CA19-9 combined with neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), monocyte lymphocyte ratio (MLR) and systemic immune inflammation index (SII) in extrahepatic cholangiocarcinoma (ECC). Methods: 150 patients with ECC treated in Qingdao Municipal Hospital from January 2012 to September 2021 were selected as the cholangiocarcinoma group and 150 healthy patients as the control group. CA19-9, neutrophil lymphocyte ratio (NLR), platelet lymphocyte ratio (PLR), monocyte lymphocyte ratio (MLR) and systemic immune inflammation index (SII) were detected and analyzed. The diagnostic efficiency of single and combined parameters for ECC was evaluated by the ROC (receiver operating characteristic) curve. Results: The levels of CA19-9, NLR, PLR, MLR and SII in ECC group were higher than those in control group (P < 0.05). The ROC curve analysis showed that the areas under the ROC curve corresponding to the diagnosis of ECC by CA19-9, NLR, PLR, MLR and SII were 0.899, 0.869, 0.857, 0.796 and 0.884 respectively. The diagnostic sensitivity of NLR, PLR, MLR and SII was 68.70%, 74.00%, 72.70% and 79.30% respectively, and the specificity was 94.00%, 84.00%, 76.00% and 87.30% respectively. The area under the curve of CA19-9 combined with NLR, PLR, MLR and SII was 0.975, and the sensitivity and specificity were 92.00% and 96.70%. Conclusion: CA19-9, NLR, PLR, MLR and SII are increased in patients with ECC, which is of certain value for the diagnosis of ECC. Combined diagnosis has higher diagnostic efficiency than single index.