本文關(guān)鍵詞： 子宮內(nèi)膜病變 子宮內(nèi)膜癌 血常規(guī)參數(shù) 相關(guān)性　出處：《大連醫(yī)科大學》2017年碩士論文　論文類型：學位論文

【摘要】：目的:本研究通過回顧性分析術(shù)前外周血中中性粒細胞/淋巴細胞比值(NLR)和血小板/淋巴細胞比值(PLR)等血常規(guī)參數(shù)在子宮內(nèi)膜不同病變患者間的差別及其與子宮內(nèi)膜癌患者臨床病理特征的關(guān)系,探討血常規(guī)參數(shù)與子宮內(nèi)膜病變的相關(guān)性。方法:搜集大連醫(yī)科大學附屬大連市婦產(chǎn)醫(yī)院2010年1月至2015年12月因子宮內(nèi)膜病變進行手術(shù)治療的患者,依照術(shù)后病理回報將患者進行分組,子宮內(nèi)膜癌組273例,增生組34例,息肉組42例。其中子宮內(nèi)膜癌患者Ⅰ期227例,Ⅱ期19例,Ⅲ期27例,Ⅳ期0例;腺癌261例,漿液性癌7例,透明細胞癌4例,小細胞癌1例;子宮內(nèi)膜腺癌患者按分化程度分為高分化(G1)19例,中分化(G2)197例,低分化(G3)57例;189例患者行盆腔/腹主動脈旁淋巴結(jié)清掃術(shù),其中淋巴結(jié)轉(zhuǎn)移陽性者14例,陰性者175例。比較各組患者的外周血白細胞計數(shù)、血紅蛋白濃度、血小板計數(shù)、平均血小板體積(MPV),血小板分布寬度(PDW)、NLR、PLR、單核細胞與淋巴細胞比值(MLR)等血常規(guī)參數(shù)的差別;分析子宮內(nèi)膜癌患者的臨床病理特征與不同血常規(guī)參數(shù)之間的關(guān)系。結(jié)果:1、子宮內(nèi)膜癌組、增生組及息肉組三組患者的血紅蛋白濃度、血小板計數(shù)有明顯差異(P=0.041、0.023)。PLR在子宮內(nèi)膜癌組、增生組及息肉組的中位數(shù)分別為116.29,120.76,98.99,具有顯著差異(P=0.042),且子宮內(nèi)膜癌組及增生組患者的PLR高于息肉組患者,差異具有統(tǒng)計學意義(P=0.036,0.017)。而白細胞計數(shù)、中性粒細胞計數(shù)、平均血小板體積(MPV),血小板分布寬度、NLR、MLR等血常規(guī)參數(shù)比較無差異。2、在子宮內(nèi)膜癌患者中,手術(shù)病理分期為Ⅰ、Ⅱ、Ⅲ期患者的NLR中位數(shù)分別為1.57,1.64及1.74,具有顯著差異(P=0.049),子宮內(nèi)膜癌Ⅱ、Ⅲ期患者的NLR高于Ⅰ期患者,Ⅲ期患者與Ⅰ期患者之間具有顯著差異(P=0.049)。而NLR在不同病理分級的患者及淋巴結(jié)是否轉(zhuǎn)移患者的差異均無統(tǒng)計學意義。子宮內(nèi)膜癌Ⅰ、Ⅱ、Ⅲ期患者血紅蛋白濃度中位數(shù)分別為135g/L、124g/L及129g/L,有顯著差異(P=0.005),子宮內(nèi)膜癌Ⅱ、Ⅲ期患者的血紅蛋白濃度低于Ⅰ期患者,Ⅱ期患者與Ⅰ期患者比較具有顯著差異(P=0.003)。不同病理分級患者的血紅蛋白濃度比較,有顯著差異(P=0.015),高分化患者的血紅蛋白濃度高于中低分化患者,比較具有統(tǒng)計學意義(P=0.028,0.004)。而淋巴結(jié)是否轉(zhuǎn)移患者的血紅蛋白濃度的差異無統(tǒng)計學意義。PLR在不同手術(shù)病理分期的差異、不同病理分級的差異及淋巴結(jié)是否轉(zhuǎn)移患者的差異均不具有統(tǒng)計學意義。結(jié)論:1、子宮內(nèi)膜癌患者及子宮內(nèi)膜增生患者較子宮內(nèi)膜息肉患者的血小板及PLR偏高,說明子宮內(nèi)膜惡性病變患者可能出現(xiàn)血小板數(shù)量及PLR增高;PLR增高可反映子宮內(nèi)膜病變的嚴重程度。2、子宮內(nèi)膜癌患者NLR的增高與腫瘤分期有關(guān),隨著子宮內(nèi)膜癌手術(shù)病理分期的增加,其NLR逐漸升高,說明子宮內(nèi)膜癌患者的NLR可能與腫瘤進展有關(guān)。3、子宮內(nèi)膜癌患者病情的加重,導致其貧血程度的加重。
[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.

【學位授予單位】：大連醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R737.33

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