FRA、Adropin和HE4联合检测在子宫内膜癌疾病诊断中的意义研究  

The Significance of Combined Detection of Serum FRA,Adropin and HE4 in the Diagnosis of Endometrial Cancer

作　　者：杨静 张红 YANG Jing;ZHANG Hong(Department of Obstetrics and Gynecology,Karamay people's Hospital,Karamay 834000,China;Department of nephropathy,Karamay people's Hospital,Karamay 834000,China)

机构地区：[1]克拉玛依市人民医院妇产科,新疆克拉玛依834000 [2]克拉玛依市人民医院肾病科,新疆克拉玛依834000

出　　处：《标记免疫分析与临床》2018年第11期1639-1643,共5页Labeled Immunoassays and Clinical Medicine

摘　　要：目的探讨血清叶酸受体α(FRA)、adropin和人血清附睾蛋白4(HE4)联合检测在子宫内膜癌(EC)诊断中的意义。方法选择2016年3月至2018年3月在我院接受治疗的93例EC患者(EC组)、96例子宫良性疾病患者(子宫良性疾病组)和100例健康女性(对照组)作为研究对象进行研究。应用酶联免疫吸附试验检测并比较各组研究对象的血清FRA、adropin和HE4表达水平,应用Pearson相关性分析对三项指标之间的相关性进行分析,采用受试者工作特征曲线(ROC),计算曲线下面积(AUC),评价血清FRA、adropin和HE4联合检测诊断子宫内膜癌的价值。结果 EC组血清FRA为1614±191pg/mL,adropin为1.94±0.75ng/mL,HE4为106.57(22.39～1411. 12)pmol/L,子宫良性疾病组分别为1142±156pg/mL、9. 07±2.57ng/mL和31. 02(13. 05～163. 02) pmol/L,对照组分别为448±153pg/mL、14. 52±7. 60ng/mL和15.61(11.37～48.29)pmol/L,其中EC组和子宫良性疾病组的FRA和HE4均显著高于对照组,adropin则显著低于对照组,EC组和子宫良性疾病组比较,差异也具有统计学意义(P<0.05),且子宫良性疾病组的FRA和HE4也显著高于对照组,adropin显著低于对照组(P <0.05)。EC组患者中临床分期≥II期者,深肌层浸润患者的血清FRA和HE4显著高于I期者和浅肌层浸润者,adropin则显著低于I期者和浅肌层浸润者(P<0. 05);而不同年龄段、不肿瘤分化程度、绝经情况和病理类型者血清FRA、adropin和HE4水平比较均无显著性差异(P>0.05)。EC组患者血清HE4和FRA水平呈正相关(r=0.604,P <0.001),血清HE4、FRA均与adropin水平呈负相关(r=-0.379,P=0.026;r=-0.442,P=0.002)。应用ROC评价FRA、HE4、adropin联合检测诊断EC的AUC为0. 951 (95%CI:0.893～0. 980)灵敏度为91.96%。结论 :子宫内膜癌患者血清adropin水平降低,FRA和HE4水平升高,三者可作为子宫内膜癌的血清学标志物,且三者血清水平的联合检测有助于子宫内膜癌的诊断。Objective To investigate the significance of combined detection of serum folate receptor alpha(FRA),adropin protein and human serum epididymis 4(HE4) in the diagnosis of endometrial carcinoma(EC). Methods 93 patients with EC(EC group),96 patients with benign uterine diseases(benign uterine disease group) and 100 healthy women(control group) were selected as the subjects. Enzyme linked immunosorbent assay( ELISA) was used to detect the levels of serum FRA, adropin and HE4, and the correlationsamong the three indexes were analyzed. The subjects’ work characteristic curve(ROC) and area under the curve( AUC) were used to evaluate the diagnosis value of EC. Results The serum FRA in EC group was 1614 ±191 pg/mL,adropin 1.94 ±0.75 ng/mL,and HE4 106.57(22.39-1411.12)pmol/L,and those in the group of benign uterine diseases were 1142 ± 156 pg/mL,9. 07 ± 2. 57 ng/mL and 31. 02(13. 05-163.02)pmol/L,while the control group were 448 ± 153 pg/mL, 14. 52 ± 17. 60 ng/mL,and5. 61(11. 37-48.29)pmol/L. The FRA and HE4 of the EC group and the benign uterine disease group were significantly higher than those of the control group,and the adropin was significantly lower than that of the control group.The differences between the EC group and the benign uterine disease group were also statistically significant(P <0.05),also the FRA and HE4 in the benign uterine disease group were significantly higher than those in the control group,while adropin was significantly lower than that of the control group(P <0. 05). In group EC,the serum FRA and HE4 of patients with clinical stage beyond stage II and deep myometrium infiltration were significantly higher than those of patients with stage I and superficial musculus infiltration, and adropin was significantly lower than those of stage I and superficial musculus infiltration patients(P < 0. 05). There were no significant differences in serum FRA, adropin and HE4 levels across groups with different age,degrees of non-tumor differentiation, menopause and pathological type(P >0.05). The serum

关 键 词：子宫内膜癌 诊断标志物 叶酸受体Α Adropin 人附睾蛋白4 

分 类 号：R737.33[医药卫生—肿瘤]