Objective To explore the clinical significance of neutrophil /lymphocyte ratio (NLR ) in differential diagnosis before operation between vulvar squamous cell carcinoma ( VSCC ) and vulvar intraepithelial neoplasia ( VIN ) . M ethods A retrospective analysis was carried out about the clinical data of 132 patients with VSCC and 34 patients with VIN who were admitted and treated in our hospital from January 2012 to August 2016 .These patients were divided into VSCC group (n=132) and VIN group (n=340),moreover,the other 100 healthy subjects were served as control group .The patient's symptoms and signs ,preoperative peripheral complete blood cell count and NLR were analyzed and compared among the three groups.Moreover the single factor analysis and ROC curve were used to analyze the cilical value of preoperative NLR in differential diagnosis between VSCC and VIN .Results A total of 266 subjects were included and their data were complete . The average age and delivery times in VSCC group were significantly higher than those in VIN group (P<0.05).The lesions size in VSCC group was bigger than that in VIN group (46.1 ±2.69cm vs 2.30 ±1.12cm,P<0.05).The white blood cell count (7.57 ±2.61),neutrophils count (5.61 ±2.50), NLR (4.76 ±3.36) in VSCC group were significantly higher than those in VIN group (WBC:5.98 ±1.82,neutrophils count:4.23 ±1.59,NLR:2.65 ±1.12,P<0.05).The lymphocyte counts in VSCC group (1.62 ±0.65) and VIN group (1.78 ±0.66) were obviously higher than those (2.13 ±0.91)in control group (P<0.05).However there were no significant differences in eosinophilic count ,basophils count,mononuclear and lymphocyte count between the two groups (P>0.05).The NLR in VSCC group and VIN group was closely retaled with vulvar lesion size (P<0.05).The best cut value of NLR was 2.98,the area under curve was 0.749 ,moreover, the sensitivity and specificity of differential diagnosis between VSCC and VIN were 68.9%, 82.4%, respectively.Conclusion The NLR can be regarded as a preoperative auxiliary diagnosis method in differential diagnosis between VSCC and VIN .Moreover NLR 2.98 should be used as cut-off value of differential diagnosis between VSCC and VIN .%目的 探讨中性粒细胞与淋巴细胞比值(neutrophit-to-lymphocyte ratio,NLR)对外阴鳞状细胞癌(vulvar squamous cell carcinoma,VSCC)与外阴鳞状上皮内瘤变(vulvar intraepithelial neoplasia,VIN)术前鉴别诊断的临床意义.方法 回顾性分析就诊并经手术治疗确诊的外阴鳞癌患者132例,外阴上皮内瘤变患者34例,并选取来医院健康体检的正常对照组100例,对3组病例的症状、体征及术前外周全血细胞计数及中性粒细胞与淋巴细胞比值进行分析,通过单因素、多因素分析以及绘制ROC曲线来分析术前外周血NLR对术前鉴别外阴鳞癌与癌前病变的价值.结果 研究对象共266例,资料数据完整.VSCC组平均年龄、分娩次数均大于VIN组,差异有统计学意义(P<0览.05);VSCC组病灶大小明显大于VIN组,差异有统计学意义(P<0.05);VSCC组白细胞值、中性粒细胞绝对值、NLR均大于VIN组,差异有统计学意义(P<0.05);外阴病变2组的淋巴细胞绝对值均大于健康对照组,差异有统计学意义(P<0.05);其他白细胞分类计数项目组间差异无统计学意义(P>0.05);外阴病变2组的NLR与病灶大小具有相关性(P<0.05);NLR的最佳界定值为2.98,曲线下面积为0.749,鉴别诊断外阴鳞癌与外阴鳞状上皮内瘤变的敏感性为68.9%,特异性为82.4%.结论 NLR可作为一种术前辅助诊断方法,用于鉴别外阴鳞癌及外阴鳞状上皮内瘤.将NLR 2.98作为外阴鳞癌和外阴鳞状上皮内瘤变鉴别诊断的界定值.
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