术前NLR、PLR对评估结直肠息肉病理级别的临床价值分析

Clinical Value Analysis of Preoperative NLR and PLR in Evaluating the Pathological Grade of Colorectal Polyps

摘要: 目的：分析术前NLR、PLR与结直肠息肉病理级别的相关性，评估其对判断结直肠息肉癌变的临床价值。方法：回顾性分析青岛大学附属医院5525例瘤变或癌变的结直肠息肉患者，根据病理级别分为低级别瘤变组、高级别瘤变组、癌变组，分别3990例、451例和1084例，对各组NLR、PLR进行统计学分析。结果：不同病例组间NLR (H = 2243.238, P < 0.01)、PLR (H = 92007.94, P < 0.01)差异有统计学意义。各组NLR中位数随病理级别的升高依次增大(1.76、2.56、2.88)，癌变组明显高于其他组；各组PLR中位数随病理级别的升高依次增大(119.83、155.65、176.02)，癌变组明显高于其他组。Spearman秩相关分析显示不同病理级别和NLR、PLR间存在正相关性(P < 0.01)。在分层统计时，三组NLR均主要集中在0~4区段(85.4%、61.0%、59.6%)；PLR主要集中在100~200区段(54.2%、50.6%、44.4%)。结论：NLR、PLR可以作为结直肠息肉病理级别升高的预测指标，对结直肠息肉发生高级别瘤变或癌变有一定的警示作用，但对高级别瘤变和癌变的鉴别诊断的价值、与息肉病理级别的计量对应关系有待进一步研究。

Abstract: Objective: To analyze the correlation between preoperative NLR, PLR and the pathological grade of colorectal polyp, and to evaluate their clinical value in the judgment of colorectal polyp canceration. Methods: A total of 5525 cases of colorectal polyps with neoplasia or canceration were retrospectively analyzed in The Affiliated Hospital of Qingdao University. According to pathological grade, they were divided into low grade tumor group, high grade tumor group and canceration group, 3990 cases, 451 cases and 1084 cases, respectively. NLR and PLR were statistically analyzed in each group. Results: There were significant differences in NLR (H = 2243.238, P < 0.01) and PLR (H = 92007.94, P < 0.01) among different case groups. The median NLR of each group increased with the increase of pathological grade (1.76, 2.56, 2.88), and the cancer group was significantly higher than that of other groups; the median PLR of each group increased with the increase of pathological grade (119.83, 155.65 and 176.02), and the cancer group was significantly higher than other groups. Spearman rank correlation analysis showed that there was a positive correlation between different pathological grades and NLR and PLR (P < 0.01). In stratified statistics, the NLR of the three groups was mainly concentrated in the 0~4 section (85.4%, 61.0%, 59.6%); PLR is mainly concentrated in 100~200 sections (54.2%, 50.6%, 44.4%). Conclusion: NLR and PLR can be used as predictors of pathological grade elevation of colorectal polyps, suggesting high-grade neoplasia or canceration of colorectal polyps to some extent. However, the value of differential diagnosis of high-grade neoplasia and canceration as well as the quantitative relationship between them and pathological grade of polyps need to be further studied.