全身免疫炎症指数在非小细胞肺癌患者临床辅助诊断及进展监测中的意义

doi:10.3969/j.issn.1004-616x.2025.05.004

摘要/Abstract

摘要： 目的：探讨全身免疫炎症指数(SII)在非小细胞肺癌(NSCLC)患者临床辅助诊断及进展监测中的意义。方法：选取2020年12月—2024年2月河北医科大学第四医院收治的60例NSCLC 患者作为NSCLC 组，并收集患者初诊时的各项临床资料及血液学指标。另选取20例无恶性病变的肺良性结节患者和30例健康体检者，分别作为肺良性结节组和对照组。对比3组患者之间实验室检测指标的差异，并分析肺良性结节与不同分期NSCLC组间SII等炎症指标的表达水平。采用受试者工作特征曲线(ROC)评估SII等炎症指标和癌胚抗原(CEA)对 NSCLC 鉴别诊断和进展监测中的价值；分析其与 NSCLC 患者临床病理指标之间的相关性。结果：NSCLC组的SII、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、CEA含量、中性粒细胞计数(NE)和淋巴细胞计数(LY)水平均明显高于对照组(均为P<0.05)，NSCLC组的SII、NLR、NE中位值明显高于肺良性结节组(均为P<0.05)。SII联合CEA以及SII与NLR、PLR、CEA联合检测对鉴别诊断NSCLC与肺良性结节组的临床价值最高，且对NSCLC临床进展的预测价值高于各指标单独检测(P<0.05)。与低SII组或低NLR组患者比较，高SII组与高NLR组的T分期、M分期和TNM分期均上升(P<0.05)；与低PLR组患者相比，高PLR组的T分期上升(P<0.05)；与低CEA组患者相比，高CEA组的N分期、M分期和TNM分期上升(P<0.05)。结论：联合SII等炎症指标对NSCLC临床辅助诊断和进展监测的效能比单独检测CEA更高，具有较高的临床应用价值。

关键词: 非小细胞肺癌, 全身免疫炎症指数, 癌胚抗原, 辅助诊断, 进展监测

Abstract: OBJECTIVE：To investigate the significance of systemic immunoinflammatory index (SII) in the clinical diagnosis and progression monitoring of patients with non-small cell lung cancer (NSCLC). METHODS： A total of 60 patients with NSCLC admitted to the Fourth Hospital of Hebei Medical University from December 2020 to February 2024 were selected as the NSCLC group，and the clinical data and hematological indexes of the patients at the time of initial diagnosis were collected. In addition， 20 patients with benign pulmonary nodules without malignant lesions and 30 healthy subjects without benign and malignant tumors were selected as the benign pulmonary nodules group and control group，respectively. Differences in indicators among the three groups were compared，and the expression levels of indicators in benign pulmonary nodules and different TNM stages were analyzed. ROC was used to evaluate the value of inflammatory indicators such as SII and carcinoembryonic antigen (CEA) in the differential diagnosis and prediction on progression of NSCLC. Their correlations with clinical pathological indicators of NSCLC patients. RESULTS：The levels of SII， ratio of neutrophil to lymphocyte (NLR)， ratio of platelet to lymphocyte(PLR)， CEA， neutrophil count (NE) and lymphocyte count (LY) in NSCLC group were significantly higher than those in control group (P <0.05)，and the median values of SII，NLR and NE were significantly higher than those in benign pulmonary nodule group. SII combined with CEA and SII， NLR， PLR， and CEA in combination had the highest clinical value for distinguishing NSCLC from benign disease group and had a higher predictive value for clinical progression of NSCLC than single index detection. The T stage，M stage，and TNM stage were significantly higher in the high SII group and high NLR group compared with the low-SII and low-NLR group (P <0.05)，respectively. Compared with the low PLR group， the T stage was significantly higher in the high PLR group， with a statistical difference (P <0.05). Compared with the low CEA group， the N stage， M stage， and TNM stage were significantly higher in high CEA group，with statistically significant differences (P <0.05). CONCLUSION：Our data shows that SII was related to clinically assisted diagnosis and progression monitoring of NSCLC. The combination of SII and other inflammatory indicators demonstrated higher efficacy in clinically assisted diagnosis and prediction of progression of NSCLC than CEA alone，with higher clinical application value.

Key words: non-small cell lung cancer, systemic immunoinflammatory index, carcinoembryonic antigen, auxiliary diagnosis, progression monitoring

中图分类号:

R446.6

赵红峥, 叶奕良, 马鸣. 全身免疫炎症指数在非小细胞肺癌患者临床辅助诊断及进展监测中的意义[J]. 癌变·畸变·突变, 2025, 37(5): 369-374.

ZHAO Hongzheng, YE Yiliang, MA Ming. Significance of systemic immunoinflammatory index in clinical diagnosis and progression monitoring on patients with non-small cell lung cancer[J]. Carcinogenesis, Teratogenesis & Mutagenesis, 2025, 37(5): 369-374.

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