摘要
目的 探讨宫颈癌患者血清内分泌激素联合检测人附睾蛋白4(HE4)、糖类抗原125(CA125)、甲胎蛋白(AFP)的临床应用价值.方法 选取宫颈癌患者80例作为恶性组,宫颈上皮内瘤变患者80例作为良性组.比较2组血清HE4、CA125、AFP、内分泌激素[促卵泡生成素(FSH)、促黄体生成素(LH)、雌激素(E2)]水平,分析血清HE4、CA125、AFP与FSH、LH、E2的相关性,评价各血清指标联合检测对宫颈癌的诊断价值,并以最佳截断值为界分析各血清指标对宫颈癌发病风险的影响,对比恶性组不同病理特征患者血清FSH、LH、E2、HE4、CA125、AFP水平,分析各血清指标与病理特征的关系.结果 恶性组血清FSH、LH、E2、HE4、CA125、AFP水平高于良性组(P＜0.05);肿瘤直径≥4 cm、临床分期Ⅲ～Ⅳ期、低分化程度、淋巴结转移患者血清FSH、LH、E2、HE4、CA125、AFP水平分别高于肿瘤直径＜4 cm、临床分期Ⅰ～Ⅱ期、中高分化程度、无淋巴结转移患者(P＜0.05);血清HE4、CA125、AFP与FSH、LH、E2呈正相关(P＜0.05);血清FSH、LH、E2、HE4、CA125、AFP联合诊断宫颈癌的曲线下面积(AUC)为0.940(95％CI:0.892～0.972),约登指数为0.750,大于各指标单一诊断;以最佳截断值为界,血清FSH、LH、E2、HE4、CA125、AFP阳性表达患者宫颈癌发病风险分别是阴性表达患者的2.612倍、1.976倍、2.829倍、3.305倍、3.566倍、3.492倍;血清FSH、LH、E2、HE4、CA125、AFP与肿瘤直径、临床分期、淋巴结转移呈正相关,与分化程度呈负相关(P＜0.05).结论 宫颈癌患者血清FSH、LH、E2与HE4、CA125、AFP显著相关,联合诊断价值较高,还能为临床评估病情进展提供数据支持.
Abstract
Objective To investigate the clinical value of serum endocrine hormone combined with human epoetin 4(HE4),glycoantigen 125(CA125),and alpha-fetoprotein(AFP)testing in patients with cervical cancer.Methods 80 patients with cervical cancer were selected as the malignant group and 80 patients with cervical intraepithelial neoplasia as the benign group.The levels of ser-um HE4,CA125,AFP,folliculopoietin(FSH),luteinizing hormone(LH),estrogen(E2)were compared between two groups,and the correlation between serum HE4,CA125,AFP and FSH,LH,E2 was analyzed.The optimal cut-off value was used to analyze the influ-ence of each serum index.Influence of cervical cancer development risk of each serum index was analyzed by comparing the levels of ser-um FSH,LH,E2,HE4,CA125 and AFP in patients with different pathological characteristics in the malignant group.Results Serum FSH,LH,E2,HE4,CA125 and AFP levels were higher in the malignant group than those in the benign group(P＜0.05).Serum FSH,LH,E2,HE4,CA125 and AFP levels were higher in patients with tumor diameter ≥4 cm,clinical stage Ⅲ～Ⅳ,low degree of differentia-tion and lymph node metastasis than those in patients with tumor diameter＜4 cm,clinical stage Ⅰ-Ⅱ,medium to high degree of differen-tiation and no lymph node metastasis,respectively(P＜0.05).Serum HE4,CA125 and AFP were positively correlated with FSH,LH and E2(P＜0.05).The area under curve(AUC)for the combined diagnosis of cervical cancer with serum FSH,LH,E2,HE4,CA125,and AFP were respectively 0.940(95％CI:0.892～0.972),with a Yordon index of 0.750,which was greater than the single diagnosis of each index;using the best cut-off value as the boundary,the risk of cervical cancer in patients with positive expression of serum FSH,LH,E2,HE4,CA125,and AFP were 2.612 times,1.976 times,2.829 times,3.305 times,3.566 times,and 3.492 times higher than those of patients with negative expression,respectively;serum FSH,LH,E2,HE4,CA125,and AFP were positively correlated with tumor diameter,clinical stage,and lymph node metastasis,and negatively correlated with the degree of differentiation(P＜0.05).Conclusion Serum FSH,LH and E2 are significantly correlated with HE4,CA125 and AFP in patients with cervical cancer,and the combined diagnostic value is more reliable and also provides data to support clinical assessment of disease progression.
基金项目
宁夏医科大学校级科研课题计划(XT202000423)
维普
万方数据