解放军医学杂志2025，Vol.50Issue(8)：964-969,6.DOI:10.11855/j.issn.0577-7402.0879.2025.0310
术前血红蛋白/红细胞分布宽度比值、预后营养指数及癌胚抗原在结直肠癌诊断中的应用价值
Application value of preoperative hemoglobin/red cell distribution width ratio,prognostic nutritional index,and carcinoembryonic antigen in the diagnosis of colorectal cancer
摘要
Abstract
Objective To explore the application value of preoperative hemoglobin(Hb)/red cell distribution width(RDW)ratio(HRR),prognostic nutritional index(PNI)and carcinoembryonic antigen(CEA)in the diagnosis of colorectal cancer.Methods Data were retrospectively collected from 224 colorectal cancer patients admitted to Chaohu Hospital Affiliated to Anhui Medical University from September 2019 to December 2023,designated as colorectal cancer group,and 207 patients with benign colorectal diseases during the same period,designated as control group.General information,peripheral blood red cell,white cell,neutrophil,and lymphocyte counts,as well as CEA levels,were compared between the two groups.The HRR and PNI were calculated.Factors influencing the occurrence of colorectal cancer were analyzed.Multicollinearity analysis was performed on the selected variables,and variables with a variance inflation factor(VIF)＜5 were included in the multivariate binary logistic regression analysis to identify independent influencing factors.A joint model was constructed using binary logistic regression analysis with HRR,PNI,and CEA.Receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic efficacy of HRR,PNI and CEA alone and in combination.Calibration curves and decision curve analysis(DCA)were used to evaluate the calibration and clinical utility of the joint model.Spearman rank correlation analysis was performed to assess the correlation between nutritional status of colorectal cancer patients(evaluated based on PNI values)and various nutritional indicators[body mass index(BMI),hemoglobin(Hb),albumin(ALB),red cell count and lymphocyte count].Results Compared with control group,patients in colorectal cancer group had lower level of red blood counts,HRR,and PNI,and higher levels of RDW and CEA,with statistically significant differences(P＜0.001).Binary logistic regression analysis showed that ALB,CEA,HRR and PNI were independent risk factors for colorectal carcinogenesis(P＜0.05 or P＜0.01).ROC curve analysis revealed that HRR had the largest area under the curve(AUC)for diagnosing colorectal cancer(0.721),while PNI had the highest sensitivity(64.2％).The combined diagnosis of colorectal cancer using HRR,PNI and CEA had an AUC of 0.784,with the sensitivity and specificity of 67.0％and 84.1％,respectively.Internal validation,calibration curves,and DCA indicated that the joint model had good discrimination,consistency,and clinical performance.Spearman rank correlation analysis showed significant correlations between Hb,ALB levels,red cell and lymphocyte counts,and PNI(P＜0.05).The worse the nutritional status of colorectal cancer patients(the lower PNI values),the lower the values of nutritional indicators.Conclusions HRR and PNI have important diagnostic value for colorectal cancer and can improve diagnostic efficacy when combined with CEA.Moreover,PNI can effectively assess the nutritional status of colorectal cancer patients.关键词
血红蛋白/红细胞分布宽度比值/预后营养指数/结直肠癌/诊断效能Key words
hemoglobin to erythrocyte distribution width ratio/prognostic nutritional index/colorectal cancer/diagnostic efficacy分类
医药卫生引用本文复制引用
陈玉婷,路亮..术前血红蛋白/红细胞分布宽度比值、预后营养指数及癌胚抗原在结直肠癌诊断中的应用价值[J].解放军医学杂志,2025,50(8):964-969,6.基金项目
This work was supported by the Natural Science Research Project of Anhui Universities(KJ2021A0337) 安徽高校自然科学研究项目(KJ2021A0337) （KJ2021A0337）
