术前外周血营养指标鉴别腮腺肿瘤性质的价值分析

Value of preoperative peripheral blood nutritional parameters in differentiating benign from malignant parotid gland tumors

摘要

目的 探讨术前外周血营养指标鉴别腮腺肿瘤性质的价值。方法 回顾性分析2015年1月至2025年3月于大连医科大学附属第二医院接受治疗的75例腮腺恶性肿瘤患者（恶性组）和79例腮腺良性肿瘤患者（良性组）的临床资料。比较两组间术前总蛋白（TP）、白蛋白（Alb）、前白蛋白（PA）、球蛋白（Glb）、白蛋白/球蛋白比值（AGR）、载脂蛋白A1（ApoA1）、载脂蛋白B（ApoB）、载脂蛋白A1与载脂蛋白B比值（ApoA1/ApoB）等外周血营养指标的差异，多因素Logistic回归分析筛选腮腺恶性肿瘤的独立危险因素，并通过受试者工作特征（ROC）曲线评估各指标的诊断价值。结果 两组间TP、Alb、PA、ApoA1、ApoB、AGR、ApoA1/ApoB水平差异均有统计学意义（P＜0.05）。恶性组的ApoA1、ApoA1/ApoB均高于良性组；TP、Alb、PA、AGR、ApoB均低于良性组。多因素Logistic回归分析结果显示，Alb、PA、ApoA1/ApoB是发生腮腺恶性肿瘤的独立危险因素（P＜0.05）。ROC曲线分析结果显示，诊断腮腺恶性肿瘤Alb、PA、ApoA1/ApoB的最佳临界值分别为41.42 g/L、250.94 mg/L、1.455 g/L，对应的曲线下面积（AUC）分别为0.747（95%CI 0.671～0.813）、0.686（95%CI 0.606～0.758）、0.648（95%CI 0.567～0.723）。结论 Alb、PA、ApoA1/ApoB在鉴别腮腺良恶性肿瘤中具有一定价值，可为腮腺肿瘤提供新的术前辅助诊断方法。

Abstract

Objective To explore the value of preoperative peripheral nutritional markers in differentiating the nature of parotid tumors. Methods Clinical data of 75 patients with malignant parotid gland tumors (malignant group) and 79 patients with benign parotid gland tumors (benign group) treated at the Second Affiliated Hospital of Dalian Medical University between January 2015 and March 2025 were retrospectively analyzed. Preoperative peripheral nutritional markers, including total protein (TP), albumin (Alb), prealbumin (PA), globulin (Glb), albumin-to-globulin ratio (AGR), apolipoprotein A1 (ApoA1), apolipoprotein B (ApoB), and apolipoprotein A1-to-apolipoprotein B ratio (ApoA1/ApoB) were compared between the two groups. Multivariate logistic regression analysis was performed to identify independent risk factors for malignant parotid tumors, and receiver operating characteristic (ROC) curves were constructed to evaluate the diagnostic value of each indicator. Results Significant differences were observed in TP, Alb, PA, ApoA1, ApoB, AGR, and ApoA1/ApoB between the two groups (P＜0.05). The levels of ApoA1 and ApoA1/ApoB were higher in the malignant group than in the benign group, whereas the levels of TP, Alb, PA, AGR and ApoB in the malignant group were lower than those in the benign group. Multifactorial logistic regression analysis showed that Alb, PA, and ApoA1/ApoB were independent risk factors for parotid malignancy (P＜0.05). The optimal cutoff values for diagnosing parotid malignancy were 41.42 g/L for Alb, 250.94 mg/L for PA, and 1.455 g/L for ApoA1/ApoB, with corresponding areas under the curve (AUCs) of 0.747 (95%CI 0.671-0.813), 0.686 (95%CI 0.606-0.758), and 0.648 (95%CI 0.567-0.723), respectively. Conclusion Alb, PA, ApoA1/ApoB are valuable in differentiating benign and malignant parotid gland tumors, and may serve as novel preoperative auxiliary diagnostic indicators for parotid tumors.

关键词

腮腺肿瘤 / 外周血 / 营养标志物

Key words

parotid tumors / peripheral blood / nutritional parameters

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