LDH、PLR、NLR、SII及D-二聚体对子宫肉瘤的联合诊断价值分析
Analysis of Combined Diagnostic Value of LDH, PLR, NLR, SII and D-Dimer in Uterine Sarcoma

目的：探讨术前乳酸脱氢酶(LDH)、中性粒细胞/淋巴细胞比值(NLR)、血小板/淋巴细胞比值(PLR)、系统性免疫性炎症指数(SII)水平及D-二聚体对子宫肉瘤的联合诊断价值。方法：回顾性分析2018年12月至2021年12月在青岛大学附属医院经手术治疗的63例子宫肉瘤患者的临床资料。按1:2比例选取同期经手术病理证实的126例子宫肌瘤患者作为子宫肌瘤组。统计分析所有患者术前一般资料，1周内外周血血常规、D-二聚体、LDH结果，计算NLR、PLR、SII值，比较各指标数值在两组间的差异。检测LDH、D-二聚体、NLR、PLR和SII5个指标及其联合检测对子宫肉瘤的诊断价值。结果：子宫肉瘤组外周血LDH、D-二聚体、NLR、SII值水平均高于子宫肌瘤组，差异有统计学意义(P < 0.05)。但子宫肉瘤组PLR水平均小于子宫肌瘤组，差异有统计学意义(P < 0.05)。血清LDH、D-二聚体、NLR、PLR和SII诊断子宫肉瘤的受试者工作特征曲线下面积(AUC)分别为0.664、0.746、0.851、0.597、0.597，五指标联合诊断的AUC为0.949，其灵敏度和准确度均高于单项检测，差异有统计学意义(P < 0.05)。结论：术前LDH、D-二聚体、NLR、PLR和SII对子宫肉瘤的早期诊断及鉴别诊断具有临床实用价值。其联合检测优于单项检测，具有较好的临床诊断价值。
Purpose: To investigate the combined diagnostic value of lactate dehydrogenase (LDH), neutro-phil/lymphocyte ratio (NLR), platelet/lymphocyte ratio (PLR), systemic immune inflammatory in-dex (SII) and D-dimer in uterine sarcoma. Methods: The clinical data of 63 patients with uterine sarcoma who underwent surgical treatment in the Affiliated Hospital of Qingdao University from December 2018 to December 2021 were retrospectively analyzed. 126 patients with hysteromyo-ma confirmed by surgery and pathology during the same period were selected as the hysteromyo-ma group in a ratio of 1:2. Preoperative general data of all patients, peripheral blood routine, D-dimer and LDH results within 1 week were statistically analyzed, and the values of NLR, PLR and SII were calculated to compare the differences of each index value between the two groups. LDH, D-dimer, NLR, PLR and SII were detected and their combined detection value in the diagnosis of uterine sarcoma was compared. Results: The levels of LDH, D-dimer, NLR and SII in peripheral blood of uterine sarcoma group were higher than those of uterine fibroids group, with statistical signifi-cance (P < 0.05). However, PLR levels in the uterine sarcoma group were lower than those in the uterine fibroids group, and the difference was statistically significant (P < 0.05). The areas under the receiver operating characteristic curve (AUC) of serum LDH, D-dimer, NLR, PLR and SII in the diagnosis of uterine sarcoma were 0.664, 0.746, 0.851, 0.597 and 0.597, respectively, and the AUC of the combined diagnosis of the five indicators was 0.949, which showed higher sensitivity and ac-curacy than that of single detection. The difference was statistically significant (P < 0.05). Conclusion: Preoperative LDH, D-dimer, NLR, PLR and SII have clinical value in the early diagnosis and differen-tial diagnosis of uterine sarcoma. Its combined detection is superior to single detection and has good clinical diagnostic value.