Page 77 - 南京医科大学学报自然科学版

第41卷第5期 南京医科大学学报（自然科学版）
2021年5月 Journal of Nanjing Medical University（Natural Sciences） ·707 ·

·临床医学·

炎症指标在胰腺导管内乳头状黏液性肿瘤恶变的诊断价值

邱辰杰 ，王雪冰 ，李海峰 ，陆子鹏 ，张 凯 ，蒋奎荣 ，苗 毅 ，高文涛 1*
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南京医科大学第一附属医院胰腺中心，江苏 南京 210029，东南大学医学院，江苏 南京 210009
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［摘 要］ 目的：探讨炎症指标，包括中性粒细胞/淋巴细胞（neutrophil to lymphocyte，NLR）和血小板/淋巴细胞（platelet to lym⁃
phocyte，PLR）在胰腺导管内乳头状黏液性肿瘤（intraductal papillary mucinous neoplasm，IPMN）恶变中的诊断价值。方法：回顾
性分析南京医科大学第一附属医院2015年1月—2020年12月的IPMN手术患者，均由组织病理学明确诊断。收集患者一般信
息、临床指标、影像指标、炎症指标，采用列线图构建恶性IPMN 的预测模型。结果：NLR、PLR、CA19⁃9、癌胚抗原（carcino em⁃
bryonic antigen，CEA）、囊肿大小、增强壁结节、胰管口径突然改变均与IPMN的恶性进展相关。NLR、CA19⁃9及囊肿大小为预
测恶性IPMN的独立危险因素。PLR及囊肿大小为预测IPMN伴高级别不典型增生（high grade dysplasia，HGD）的独立危险因
素。CA19⁃9 为 IPMN 伴浸润性癌（intraductal papillary mucinous carcinoma，IPMC）的独立危险因素。基于 NLR、CA19⁃9 和囊肿
大小的预测恶性 IPMN 的曲线下面积为 0.806。该预测模型有较好的预测效能。结论：NLR、CA19⁃9 和囊肿大小为预测恶性
IPMN的独立危险因素，PLR和囊肿大小为预测HGD的独立危险因素。炎症指标在IPMN的恶性进展中发挥重要作用，可作为
福冈指南的有益补充。
［关键词］ 胰腺导管内乳头状黏液性肿瘤；中性粒细胞/淋巴细胞比值；血小板/淋巴细胞比值；福冈指南
［中图分类号］ R735.9 ［文献标志码］ A ［文章编号］ 1007⁃4368（2021）05⁃707⁃07
doi：10.7655/NYDXBNS20210512

Diagnostic value of inflammatory markers in malignant transformation of intraductal
papillary mucinous neoplasm of pancreas

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QIU Chenjie ，WANG Xuebing ，LI Haifeng ，LU Zipeng ，ZHANG Kai ，JIANG Kuirong ，MIAO Yi ，GAO Wentao
1 Pancreas Center，the First Affiliated Hospital of Nanjing Medical University，Nanjing 210029；Medical School of
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Southeast University，Nanjing 210009，China

［Abstract］ Objective：This study aims to investigate the diagnostic value of inflammatory markers including neutrophil/lymphocyte
（NLR）and platelet/lymphocyte（PLR）in malignant transformation of pancreatic intraductal papillary mucinous neoplasm（IPMN）.
Methods：The IPMN patients in the First Affiliated Hospital of Nanjing Medical University from January 2015 to December 2020 were
retrospectively analyzed. The general information，clinical indexes，imaging indexes and inflammatory indexes were collected，and the
nomogram was used to construct the prognostic model of malignant IPMN. Results：NLR，PLR，CA19⁃9，（carcino embryonic antigen，
CEA），cyst size，enhanced mural nodule and abrupt changes in the pancreatic duct caliber were associated with the malignant
progression of IPMN. NLR，CA19 ⁃ 9 and cyst size were independent risk factors for malignant IPMN. PLR and cyst size were
independent risk factors for IPMN with high⁃grade dysplasia（HGD）. CA19⁃9 was an independent risk factor for IPMN with invasive
carcinoma（IPMC）. The area under the curve for predicting malignant IPMN based on NLR，CA19⁃9 and cyst size was 0.806. The
prognostic model had good prediction performance. Conclusion：NLR，CA19 ⁃ 9 and cyst size were independent risk factors for
predicting malignant IPMN，while PLR and cyst size were independent risk factors for predicting HGD. Inflammatory markers played
important role in the malignant progression of IPMN，which can be used as a useful supplement to Fukuoka guidelines.
［Key words］ Intraductal papillary mucinous neoplasm；neutrophil to lymphocyte；platelet to lymphocyte；Fukuoka guidelines
［J Nanjing Med Univ，2021，41（05）：707⁃713］

［基金项目］ 江苏省高层次卫生人才“六个一工程”拔尖人才项目（LGY2018059）
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通信作者（Corresponding author），E⁃mail：gao11@hotmail.com