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目的:评价胸片可疑肺癌病例中联合检测血小板计数及其他血液常规实验室检查来预测肺癌的可行性。方法:本研究前瞻性收集了连续189个胸片可疑肺癌患者,检测其血小板计数、血红蛋白、白细胞计数、红细胞沉降率(ESR)、血清乳酸脱氢酶。根据术后病理分为良性病例组(n=98)与恶性病例组(n=91)。肺癌病人根据TNM系统进行分期,所有肿块根据组织类型进行分型。结果:8%(8/98)的良性病例出现血小板增多症(血小板计数>400*109,)而在恶性病例中血小板增多症的发生率为57%(52/91)(p<0.0001)。其中,原发性肺癌中,血小板增多症的发病率为53%(40/76)。在肿瘤晚期病例(TNM IIII、V期)中,血小板增多症的发病率尤高。血小板增多症联合乳酸脱氢酶升高及ESR增高,则预测的敏感性可达到0.71,而特异性可达到1.00。阳性预测值为1.00,而阴性预测值为0.89。结论:肺癌病人中血小板增高症发病率较高。如果联合血小板计数与其他常规血液检测如白细胞计数、ESR及血清乳酸脱氢酶等检查,可以作为预测肺癌发生率的一个较好的指标。
OBJECTIVE: To evaluate the feasibility of combined detection of platelet counts and other routine blood tests in lung cancer in suspected chest radiographs to predict lung cancer. Methods: We prospectively collected 189 consecutive patients with suspicious lung cancer of the chest and measured their platelet count, hemoglobin, white blood cell count, erythrocyte sedimentation rate (ESR) and serum lactate dehydrogenase. According to the postoperative pathology, the patients were divided into benign cases (n = 98) and malignant cases (n = 91). Patients with lung cancer were staged according to the TNM system and all lumps were typed according to the type of tissue. Results: Thrombocytosis (platelet count> 400 * 109) was found in 8% (8/98) of the benign cases and in 57% (52/91) of the malignant cases (p <0.0001). Among them, the incidence of primary lung cancer, thrombocytosis was 53% (40/76). In advanced cancer cases (TNM IIII, V), the incidence of thrombocytosis is particularly high. Thrombocythemia combined with elevated lactate dehydrogenase and increased ESR, the predicted sensitivity can reach 0.71, while the specificity can reach 1.00. The positive predictive value was 1.00, while the negative predictive value was 0.89. Conclusions: The incidence of thrombocytosis in lung cancer patients is high. If the combined platelet count and other routine blood tests such as white blood cell count, ESR and serum lactate dehydrogenase and other tests, can be used as a predictor of lung cancer incidence of a good indicator.