中国实用外科杂志

中国实用外科杂志

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术前外周血中性粒细胞与淋巴细胞计数比鉴别甲状腺良恶性结节临床价值研究

吴    伟，张艳君，王    冰，麻    涛，周    彬，徐倪侦，田    文   

  1. 中国人民解放军总医院普通外科，北京 100853
  • 出版日期:2016-02-01 发布日期:2016-01-29

  • Online:2016-02-01 Published:2016-01-29

摘要：

目的    分析术前外周血中性粒细胞与淋巴细胞计数比（NLR）在甲状腺良恶性结节鉴别诊断中的价值。方法    回顾性分析2014-07-01—2015-06-30于中国人民解放军总医院普通外科经手术治疗的485例甲状腺结节病人的临床资料，根据术后常规病理学检查结果分为良性组和恶性组，对每组病例所对应的NLR进行对比分析，应用ROC曲线分析鉴别甲状腺良恶性结节的最佳cut-off值。结果    甲状腺结节良性组和恶性组的NLR值分别为（1.6±0.5）和（1.9±1.0），恶性组有较高的中性粒细胞计数及较低的淋巴细胞计数，两组差异有统计学意义（P<0.05）。由ROC曲线分析得出鉴别甲状腺结节良恶性的NLR最佳cut-off值为1.77，敏感度为65.8%，特异度为79.7%，AUC为0.723。结论    术前外周血NLR值可指导甲状腺良恶性结节的鉴别诊断，高NLR值预示结节恶性。

关键词: 甲状腺结节, 中性粒细胞与淋巴细胞计数比, 鉴别诊断, 炎性反应

Abstract:

Diagnostic value of preoperative peripheral blood neutrophil to lymphocyte ratio in identification of benign and malignant thyroid nodules        WU Wei，ZHANG Yan-jun，WANG Bing，et al. Department of General Surgery，Chinese People's Liberation Army General Hospital，Beijing 100853，China
Corresponding author：TIAN Wen，E-mail：tianwen301_cta@163.com
Abstract    Objective    To investigate the value of preoperative peripheral blood neutrophil to lymphocyte ratio in differential diagnosis of benign and malignant thyroid nodules. Methods    The clinical data of 485 patients with thyroid nodules after surgical treatment in the General Hospital of PLA from July 1, 2014 to June 30, 2015 were analyzed retrospectively. The patients were divided into benign nodules group and malignant nodules group according to postoperative pathologic results，and the NLR from each group was analyzed comparatively. Furthermore，the optimal cut-off value of NLR to discriminate between benign nodules and malignant nodules of thyroid was obtained by ROC. Results    NLR value was (1.6±0.5) in benign nodules group and (1.9±1.0) in malignant nodules group respectively. Malignant nodules group had higher neutrophil count and lower lymphocyte count，and NLR was significantly higher than that in benign nodules group (P<0.05). The optimal NLR cut-off point obtained from ROC analysis was 1.77 (sensitivity 65.8% and specificity 79.9%)，while AUC was 0.723. Conclusion    Preoperative peripheral blood NLR can guide the differential diagnosis of benign and malignant thyroid nodules，and high NLR indicates nodules malignant.

Key words: thyroid nodule, neutrophil to lymphocyte ratio, differential diagnosis, inflammation