Diagnostic Value Of NLR,CEA And FIB In Primary Lung Cancer

Objective:To study the diagnostic value of combined detection of Neutrophil to Lymphocyte Ratio,Carcino-embryonic Antigen and Fibrinogen in Primary lung cancer,Which is expected to provide reference for the diagnosis of early lung cancer.Methods:The primary lung cancer patients were selected as the case group in a grade A hospital,At the same time,all the patients diagnosed with benign lung disease and healthy physical examination as the control group were selected for pathological examination,And the first confirmed diagnosis of primary lung cancer patients,The disease selected by the control group was the differential diagnosis of lung cancer in internal science(Ninth Edition),and the healthy physical examination subjects were evaluated using a case-control study design,Clinical epidemiological analysis of the three indicators studied,Using the gold standard to distinguish patients with primary lung cancer,The included research subjects were then determined simultaneously blinded by using the diagnostic test to be evaluated,The authenticity of the diagnostic tests was evaluated by the Sensitivity,Specificity,Area Under Curve,Positive likelihood ratio,Negative likelihood ratio,Youden index,The reliability of the diagnostic test was evaluated by the Compliance rate,kappa.Finally,The comparative analysis of the joint diagnostic test of single index and multiple indexes was carried out.Results:(1)The expression levels of NLR,CEA and FIB in serum of 215 cases in the case group were significantly higher than those in the control group(P<0.05).(2)There was no significant difference in serum NLR,CEA and FIB expression levels among patients with different pathological types of lung cancer(P>0.05).(3)The expression levels of NLR,CEA and FIB in serum of lung cancer patients with different disease severity were significantly different(P<0.05).(4)In the detection of NLR,CEA and FIB,The sensitivity was66.51%,74.88% and 53.95% respectively,The specificity was 70.70%,78.14% and 75.81% respectively,The positive likelihood ratio was 2.27,3.43 and 2.23 respectively,The negative likelihood ratio was 0.47,0.32 and 0.61 respectively,The Youden index was 0.3721,0.5302 and 0.2977 respectively,The area under the curve was 0.714,0.799 and 0.658 respectively.(5)The coincidence rates of NLR,CEA and FIB were 86.67%,90%and 86.67% respectively.The kappa values were 0.7297(P<0.05),0.7982(P<0.05)and 0.7321(P<0.05)respectively.The results of the two repeated measurements were highly consistent.(6)When multiple indicators were tested together,The sensitivity of NLR+CEA 、 NLR+FIB 、 CEA+FIB 、 NLR+CEA+FIB were 87.44%,83.72%,87.91% and 93.02% respectively,The specificity were 55.81%,53.49%,54.88% and 39.53% respectively,The positive likelihood ratio were 1.98,1.80,1.95 and 1.54 respectively,The negative likelihood ratio were 0.23,0.30,0.22 and 0.18 respectively,and the Youden index were0.4326,0.3721,0.4279 and 0.3256 respectively,The areas under the curve are 0.738,0.817,0.816 and 0.838 respectively.(7)The sensitivity of NLR+CEA+FIB was significantly different from that of NLR,FIB and CEA(P<0.05).(8)The specificity of NLR+CEA+FIB was significantly different from that of NLR,CEA,FIB,NLR+CEA,NLR+FIB,CEA+FIB(P<0.05).(9)The area under curve NLR+CEA+FIB curve was significantly different from that under NLR,CEA,FIB,NLR+CEA,NLR+FIB and CEA+FIB curves(P<0.05).Conclusions: The expression levels of NLR,CEA and FIB in serum of the case group are higher than those of the control group,which has a certain reference value in differentiating lung cancer from benign lung diseases.The parallel test of serum NLR,CEA and FIB can improve the sensitivity of lung cancer diagnosis(93.02%),reduce the missed diagnosis rate,and have certain clinical auxiliary diagnostic value.