METHODS: A retrospective analysis was conducted on the data of 324 patients suspected of cervical lesions due to abnormal TCT and/or HPV in our hospital from January 2023 to December 2023, who underwent colposcopy. The pathological results of colposcopic biopsy confirmed that there were 140 cases of chronic cervicitis, which classified as the group without cervical lesions. The cervical lesion group included 184 cases, including 91 cases of LSIL, 71 cases of HSIL, and 22 cases of cervical cancer. Compared the differences in preoperative peripheral blood NLR, PLR, MLR, and SII among different groups of patients, and evaluated their predictive value for the severity of cervical lesions using Receiver Operating Characteristic (ROC) curves.
RESULTS: The levels of NLR, PLR, and SII in the group without cervical lesions were lower than those in the group with cervical lesions (p < 0.05), and there was no statistically significant difference in MLR (p > 0.05). The comparison of NLR among LSIL, HSIL, and cervical cancer groups showed statistically significant differences (p < 0.05), while PLR, MLR, and SII showed no statistically significant differences (p > 0.05). The AUC of peripheral blood NLR, PLR, and SII for predicting cervical lesions were 0.569, 0.582, and 0.572, respectively. The optimal cutoff values were 2.3,176.48, and 603.56. The sensitivity and specificity were 38.6% and 73.6%, 28.8% and 85.7%, 37.5% and 76.4%, respectively. At the same time, the joint testing of the three had the highest efficiency, with sensitivity of 69% and specificity of 45%.
CONCLUSIONS: Although the peripheral blood NLR, PLR, and SII of the cervical lesions patients were higher than those without cervical lesions in cervical cancer screening abnormal patients, the predictive ROC curve discrimination was low. Therefore, it is not recommended to use preoperative peripheral blood inflammatory markers as markers for cervical cancer screening abnormal patient diversion.
方法:对2023年1月至2023年12月在我院行阴道镜检查的324例因TCT和/或HPV异常而疑似宫颈病变的患者资料进行回顾性分析。阴道镜活检病理结果证实140例慢性宫颈炎,归入无宫颈病变组。宫颈病变组184例,包括91例LSIL,71例HSIL,宫颈癌22例。对比术前外周血NLR的差异,PLR,MLR,和不同组患者的SII,并使用受试者工作特征(ROC)曲线评估其对宫颈病变严重程度的预测价值。
结果:NLR的水平,PLR,无宫颈病变组SII低于有宫颈病变组(p<0.05),MLR差异无统计学意义(p>0.05)。NLR与LSIL的比较,HSIL,与宫颈癌组比较差异有统计学意义(p<0.05),而PLR,MLR,与SII比较差异无统计学意义(p>0.05)。外周血NLR的AUC,PLR,预测宫颈病变的SII分别为0.569、0.582和0.572。最佳截止值为2.3、176.48和603.56。敏感性和特异性分别为38.6%和73.6%,28.8%和85.7%,37.5%和76.4%,分别。同时,三者的联合测试效率最高,敏感性为69%,特异性为45%。
结论:尽管外周血NLR,PLR,宫颈癌筛查异常患者中宫颈病变的SII率高于无宫颈病变患者,预测ROC曲线区分度较低.因此,不建议使用术前外周血炎性标志物作为宫颈癌筛查异常转流患者的标志物.