血常规参数与子宫内膜病变相关性的初步研究

发布时间：2018-02-28 02:00

本文关键词： 子宫内膜病变子宫内膜癌血常规参数相关性　出处：《大连医科大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:本研究通过回顾性分析术前外周血中中性粒细胞/淋巴细胞比值(NLR)和血小板/淋巴细胞比值(PLR)等血常规参数在子宫内膜不同病变患者间的差别及其与子宫内膜癌患者临床病理特征的关系,探讨血常规参数与子宫内膜病变的相关性。方法:搜集大连医科大学附属大连市妇产医院2010年1月至2015年12月因子宫内膜病变进行手术治疗的患者,依照术后病理回报将患者进行分组,子宫内膜癌组273例,增生组34例,息肉组42例。其中子宫内膜癌患者Ⅰ期227例,Ⅱ期19例,Ⅲ期27例,Ⅳ期0例;腺癌261例,浆液性癌7例,透明细胞癌4例,小细胞癌1例;子宫内膜腺癌患者按分化程度分为高分化(G1)19例,中分化(G2)197例,低分化(G3)57例;189例患者行盆腔/腹主动脉旁淋巴结清扫术,其中淋巴结转移阳性者14例,阴性者175例。比较各组患者的外周血白细胞计数、血红蛋白浓度、血小板计数、平均血小板体积(MPV),血小板分布宽度(PDW)、NLR、PLR、单核细胞与淋巴细胞比值(MLR)等血常规参数的差别;分析子宫内膜癌患者的临床病理特征与不同血常规参数之间的关系。结果:1、子宫内膜癌组、增生组及息肉组三组患者的血红蛋白浓度、血小板计数有明显差异(P=0.041、0.023)。PLR在子宫内膜癌组、增生组及息肉组的中位数分别为116.29,120.76,98.99,具有显著差异(P=0.042),且子宫内膜癌组及增生组患者的PLR高于息肉组患者,差异具有统计学意义(P=0.036,0.017)。而白细胞计数、中性粒细胞计数、平均血小板体积(MPV),血小板分布宽度、NLR、MLR等血常规参数比较无差异。2、在子宫内膜癌患者中,手术病理分期为Ⅰ、Ⅱ、Ⅲ期患者的NLR中位数分别为1.57,1.64及1.74,具有显著差异(P=0.049),子宫内膜癌Ⅱ、Ⅲ期患者的NLR高于Ⅰ期患者,Ⅲ期患者与Ⅰ期患者之间具有显著差异(P=0.049)。而NLR在不同病理分级的患者及淋巴结是否转移患者的差异均无统计学意义。子宫内膜癌Ⅰ、Ⅱ、Ⅲ期患者血红蛋白浓度中位数分别为135g/L、124g/L及129g/L,有显著差异(P=0.005),子宫内膜癌Ⅱ、Ⅲ期患者的血红蛋白浓度低于Ⅰ期患者,Ⅱ期患者与Ⅰ期患者比较具有显著差异(P=0.003)。不同病理分级患者的血红蛋白浓度比较,有显著差异(P=0.015),高分化患者的血红蛋白浓度高于中低分化患者,比较具有统计学意义(P=0.028,0.004)。而淋巴结是否转移患者的血红蛋白浓度的差异无统计学意义。PLR在不同手术病理分期的差异、不同病理分级的差异及淋巴结是否转移患者的差异均不具有统计学意义。结论:1、子宫内膜癌患者及子宫内膜增生患者较子宫内膜息肉患者的血小板及PLR偏高,说明子宫内膜恶性病变患者可能出现血小板数量及PLR增高;PLR增高可反映子宫内膜病变的严重程度。2、子宫内膜癌患者NLR的增高与肿瘤分期有关,随着子宫内膜癌手术病理分期的增加,其NLR逐渐升高,说明子宫内膜癌患者的NLR可能与肿瘤进展有关。3、子宫内膜癌患者病情的加重,导致其贫血程度的加重。
[Abstract]:Objective: This study through the retrospective analysis of the neutrophil / lymphocyte ratio of preoperative peripheral blood (NLR) and platelet / lymphocyte ratio (PLR) difference of blood routine parameters in patients with endometrial lesions between the different and its relationship with clinicopathological features of endometrial cancer patients, to explore the relationship between blood parameters and endometrial lesions methods: collect Dalian Maternity Hospital Affiliated to Dalian Medical University from January 2010 to December 2015 due to endometrial lesions were surgically treated patients, according to the postoperative pathological returns of endometrial cancer patients were divided into two groups, group 273 cases, 34 cases of hyperplasia, polyps in 42 cases. 227 cases of endometrial cancer patients with stage I, 19 cases of stage, 27 cases with stage III, IV in 0 cases; 261 cases of adenocarcinoma, 7 cases of serous carcinoma, 4 cases of clear cell carcinoma, 1 cases of small cell carcinoma; endometrial adenocarcinoma patients according to the degree of differentiation into high differentiation (G1) in 19 cases. Differentiation (G2) 197 cases, low differentiation (G3) in 57 cases; 189 patients underwent pelvic / abdominal aortic dissection, 14 cases of lymph node metastasis, 175 cases were negative. The group compared with the peripheral white blood cell count, hemoglobin concentration, platelet count, mean platelet volume (MPV), platelet distribution width (PDW), NLR, PLR, monocyte and lymphocyte ratio (MLR) and other blood parameters difference; analyze the relationship between clinical and pathological features of endometrial carcinoma in patients with different blood parameters. Results: 1, endometrial cancer group, hemoglobin concentration hyperplasia and polyps group three groups of patients, the platelet count had significant difference (P=0.041,0.023).PLR in endometrial carcinoma group, median hyperplasia group and polyp group were 116.29120.76,98.99, with significant difference (P=0.042), and endometrial cancer group and hyperplasia group of patients with PLR group were higher than that of polyp , the difference was statistically significant (P=0.036,0.017). The white blood cell count, neutrophil count, mean platelet volume, platelet distribution width (MPV), NLR, MLR and other blood parameters had no significant difference between.2 in patients with endometrial cancer, surgical pathological stage I, II, III patients were median NLR for 1.57,1.64 and 1.74, with significant difference (P=0.049), II endometrial cancer, patients with NLR was higher than that of patients with significant difference between the patients with stage III patients with stage I (P=0.049). Whether NLR in patients with different pathological grading and lymph node metastasis of the patients. There were no significant differences in 1 II, endometrial cancer, patients with the median hemoglobin concentration were 135g/L, 124g/L and 129g/L, there was significant difference (P=0.005), II endometrial cancer, patients with hemoglobin concentration lower than that of stage I patients, patients with stage II and stage I The difference was significant (P=0.003). Hemoglobin concentration in different pathological grading of patients, there was significant difference (P=0.015), hemoglobin concentration high differentiation were higher than that in poorly differentiated patients, compared with statistical significance (P=0.028,0.004). But there was no statistical significance of.PLR in different clinical stages of the difference of lymph node transfer of hemoglobin concentration in patients with the difference between different pathological grading and lymph node metastasis patients, the difference was not statistically significant. Conclusion: 1 patients with endometrial carcinoma and endometrial hyperplasia patients with endometrial polyps and platelets in patients with high PLR, indicating endometrial malignant lesions may occur in patients with platelet count and PLR increased; PLR can reflect increased endometrial disease severity of.2, increased NLR in patients with endometrial cancer associated with tumor staging, surgery with endometrial carcinoma With the increase of pathological stage, the NLR gradually increased, indicating that NLR in endometrial cancer may be related to tumor progression and.3, and the aggravation of endometrial cancer aggravates the degree of anemia.

【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.33

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