研究外周血FAR、NLR、PLR等指标对结直肠腺癌的影响因素与诊断价值

Influencing Factors and Diagnostic Value of Peripheral Blood Indicators Such as FAR, NLR and PLR in Colorectal Adenocarcinoma

摘要: 目的：本研究旨在探讨结直肠腺癌患者术前外周血纤维蛋白原与白蛋白比值(FAR)、中性粒细胞与淋巴细胞比值(NLR)、血小板与淋巴细胞比值(PLR)、癌胚抗原(CEA)及糖类抗原(CA19-9)水平对结直肠腺癌的影响因素与诊断价值。方法：回顾性随机收集2018年1月至2025年3月期间就诊于安徽医科大学第四附属医院首次确诊并行手术治疗的结直肠腺癌患者177例(实验组)，同时随机挑选同时期在我院就诊的结直肠腺瘤性息肉患者204例(对照组)，收集每一位患者的FAR、NLR、PLR、CEA、CA19-9以及实验组的病理资料，所有研究对象均经组织病理学检查确诊，回顾性分析FAR、NLR、PLR、CEA及CA19-9水平对结直肠腺癌不同病理特征与诊断的临床意义。结果：腺癌实验组FAR、NLR、PLR、CEA、CA19-9等指标明显高于息肉对照组，具有统计学意义(P < 0.05)，通过指标单一与联合检测的ROC曲线分析可知：除NLR、PLR、CA19-9、NLR与PLR联合外，其余联合检测ROC的AUC值均大于0.7，其中FAR、NLR、PLR、CEA、CA19-9五者联合检测的准确性最高；在腺癌患者中，FAR水平在淋巴结是否转移、Dukes分期、分化程度有明显关联，NLR水平仅在腺癌部位有明显关联(P < 0.05)，CEA水平在淋巴结是否转移、Dukes分期有明显关联(P < 0.05)，CA19-9水平在Dukes分期、分化程度有明显关联(P < 0.05)，PLR与结直肠腺癌病理特征无明显关联(P > 0.05)。结论：FAR、NLR、PLR、CEA、CA19-9五者联合相较于单一指标检测对结直肠腺癌的诊断更有价值，且FAR、NLR、CEA、CA19-9水平各与结直肠腺癌的不同病理特征有一定的关联性。

Abstract: Objective: This study aims to explore the influencing factors and diagnostic value of preoperative peripheral blood Fibrinogen-to-Albumin Ratio (FAR), neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), carcinoembryonic antigen (CEA), and carbohydrate antigen (CA19-9) levels in patients with colorectal adenocarcinoma. Methods: A retrospective random collection was conducted on 177 patients with colorectal adenocarcinoma who were first diagnosed and underwent surgical treatment at the Fourth Affiliated Hospital of Anhui Medical University from January 2018 to March 2025 (experimental group). Meanwhile, 204 patients with colorectal adenomatous polyps who were treated in our hospital during the same period were randomly selected (control group). The pathological data of FAR, NLR, PLR, CEA, CA19-9 and the experimental group of each patient were collected. All the research subjects were diagnosed by histopathological examination. The clinical significance of FAR, NLR, PLR, CEA and CA19-9 levels for different pathological characteristics and diagnosis of colorectal adenocarcinoma was retrospectively analyzed. Results: The indicators such as FAR, NLR, PLR, CEA, and CA19-9 in the adenocarcinoma experimental group were significantly higher than those in the polyp control group, which was statistically significant (P < 0.05). Through the ROC curve analysis of single and combined detection of indicators, it can be known that: Except for NLR, PLR, CA19-9, and the combination of NLR and PLR, the AUC values of ROC in the other combined detections were all greater than 0.7. Among them, the combined detection of FAR, NLR, PLR, CEA, and CA19-9 had the highest accuracy. In patients with adenocarcinoma, the FAR level is significantly associated with whether lymph nodes have metastasized, Dukes stage, and degree of differentiation. The NLR level is only significantly associated with the adenocarcinoma site (P < 0.05), and the CEA level is significantly associated with whether lymph nodes have metastasized and Dukes stage (P < 0.05) The level of CA19-9 was significantly associated with Dukes stage and degree of differentiation (P < 0.05), while PLR was not significantly associated with the pathological characteristics of colorectal adenocarcinoma (P > 0.05). Conclusion: The combined detection of FAR, NLR, PLR, CEA and CA19-9 is more valuable for the diagnosis of colorectal adenocarcinoma compared with single index detection, and the levels of FAR, NLR, CEA and CA19-9 each have certain correlations with different pathological characteristics of colorectal adenocarcinoma.