为观察和分析血小板分布宽度（PDW）、平均血小板体积（MPV）和血清白蛋白（Alb）水平对甲状腺癌与甲状腺良性结节的鉴别价值，选择2018年12月至2020年9月在安徽省阜阳市人民医院确诊的237例甲状腺癌患者作为研究组，并抽取在该院就诊的237例良性甲状腺结节患者作为对照组。观察2组患者PDW、MPV和Alb水平及预测甲状腺癌的临床价值。结果表明：研究组MPV、Alb均低于对照组，PDW高于对照组，差异均有统计学意义（P<0.05）；PDW、MPV、Alb诊断甲状腺癌曲线下面积（AUC）相比较差异均无统计学意义（P>0.05）。PDW、MPV、Alb均阳性为检测指标特异性高于PDW、MPV、Alb单纯诊断的特异性；PDW、MPV、Alb之一阳性为检查指标灵敏度高于PDW、MPV、Alb单独诊断的灵敏度。因此，PDW、MPV和Alb对甲状腺良恶性结节的鉴别具有中等临床价值，3者不同联合方式有助于甲状腺癌确诊或排除。
In order to analyze the differential values of platelet distribution width (PDW), mean platelet volumes (MPVs), and serum albumin (ALB) levels in thyroid cancer and benign thyroid nodules, 237 patients with thyroid cancer diagnosed in the hospital from Jan. 2016 to Sept. 2020 were selected as the study group, and 237 patients with benign thyroid nodules were selected as the control group. The PDWs, ALBs and MPVs of the two groups were observed and the clinical values of predicting thyroid cancer were evaluated. Results show that MPV and ALB of the study group are lower and PDW is higher than those of the control group, and the differences are statistically significant (P<0.05). PDW, MPV,ALB in the diagnosis of thyroid cancer AUC are not statistically significant (P > 0.05). The specificity of PDW, MPV and ALB is higher than that of PDW, MPV and ALB alone, and the sensitivity of PDW, MPV and ALB is higher than that of PDW, MPV and ALB alone. Therefore, PDW, MPV and ALB are of moderate clinical value in the differential diagnosis of benign and malignant thyroid nodules. Different combination of the three indexes is helpful to the diagnosis or exclusion of thyroid cancer.
[1] Deandrea M, Trimboli P, Creanza A, et al. Long-term follow-up of cystic thyroid nodules treated with percutaneous ethanol injection (PEI) using two different approaches[J]. European Journal of Endocrinology, 2020, 183(5):489-495.
[2] Koh J, Lee E, Han K, et al. Diagnosis of thyroid nodules on ultrasonography by a deep convolutional neural network[J]. Scientific Reports, 2020, 10(1):15245.
[3] Kanikarla-Marie P, Lam M, Menter D G, et al. Platelets, circulating tumor cells, and the circulome[J]. Cancer Metastasis Reviews, 2017, 36(2):235-248.
[4] Delago D, Knittelfelder O, Jakse G, et al. The decreased mean platelet volume is associated with poor prognosis in patients with oropharyngeal cancer treated with radiotherapy[J]. Radiation oncology (London, England), 2020, 15(1):259.
[5] Kanikarla-Marie P, Lam M, Menter D G, et al. Platelets, circulating tumor cells, and the circulome[J]. Cancer Metastasis Reviews, 2017, 36(2):235-248.
[6] Son W, Shin S J, Park S H, et al. Clinical impact of combined modified glasgow prognostic score and C-reactive protein/albumin ratio in patients with colorectal cancer[J]. Diagnostics (Basel, Switzerland), 2020, 10(11):859.
[7] Chang J, Lin G, Ye M, et al. Decreased mean platelet volume predicts poor prognosis in metastatic colorectal cancer patients treated with first-line chemotherapy:Results from mCRC biomarker study[J]. BioMed Central Cancer, 2019, 19(1):15.
[8] Sakin A, Sahin S, Sakin A, et al. Mean platelet volume and platelet distribution width correlates with prognosis of early colon cancer[J]. Journal of B.U.ON.:Official Journal of the Balkan Union of Oncology, 2020, 25(1):227-239.
[9] Zhang H, Liang K, Ke L, et al. Clinical application of red cell distribution width, mean platelet volume, and cancer antigen 125 detection in endometrial cancer[J]. Journal of Clinical Laboratory Analysis, 2020, 34(8):e23309.
[10] Kuan Y C, Huang K W, Lin C L, et al. Effects of aspirin or clopidogrel on colorectal cancer chemoprevention in patients with type 2 diabetes mellitus[J]. Cancers (Basel), 2019, 11(10):1468.
[11] Li N, Lv X H, Wang X, et al. Preoperative mean platelet volume predicts survival in breast cancer patients with type 2 diabetes[J]. Breast Cancer (Tokyo, Japan), 2019, 26(6):712-718.
[12] Wu Y Y, Zhang X, Qin Y Y, et al. Mean platelet volume/platelet count ratio in colorectal cancer:A retrospective clinical study[J]. BioMed Central Cancer, 2019, 19(1):314.
[13] Tham T, Leung E, Olson C, et al. Evaluation of the prognostic utility of the combination of platelet count with mean platelet volume as a prognostic indicator in head and neck cancer[J]. Molecular and Clinical Oncology, 2019, 10(4):457-462.
[14] Song S, Cong X, Li F, et al. The fibrinogen to mean platelet volume ratio can predict overall survival of patients with non-metastatic gastric cancer[J]. Journal of Gastric Cancer, 2018, 18(4):368-378.
[15] Sakin A, Secmeler S, Arici S, et al. Prognostic significance of mean platelet volume on local advanced nonsmall cell lung cancer managed with chemoradiotherapy[J]. Scientific Reports, 2019, 9(1):3959.
[16] Taskaynatan H, Alacacioglu A, Kucukzeybek Y, et al. Is monitoring mean platelet volume necessary in breast cancer patients[J]. Open Medicine (Warsaw, Poland), 2018, 13:450-455.
[17] Huang Y, Cui M M, Huang Y X, et al. Preoperative platelet distribution width predicts breast cancer survival[J]. Cancer Biomarkers:Section A of Disease Markers, 2018, 23(2):205-211.
[18] An Q, Liu W, Yang Y, et al. Preoperative fibrinogen-toalbumin ratio, a potential prognostic factor for patients with stage IB-IIA cervical cancer[J]. BioMed Central Cancer, 2020, 20(1):691.
[19] Lee J W, Sharma A R, Lee S S, et al. The C-reactive protein to albumin ratio predicts postoperative complication in patients who undergo gastrectomy for gastric cancer[J]. Heliyon, 2020, 6(6):e04220.
[20] Kaya C, Caliskan S, Sungur M, et al. HALP score and albumin levels in men with prostate cancer and benign prostate hyperplasia[J]. International Journal of Clinical Practice, 2020, 19:e13766.
[21] Schwartz G G, Tretli S, Klug M G, et al. Women who develop ovarian cancer show an increase in serum calcium and a decrease in serum albumin. A longitudinal study in the Janus Serum Bank Cohort[J]. Gynecologic Oncology, 2020, 159(1):264-269.
