利用受试者工作特征曲线研究卵巢癌患者红细胞体积分布宽度变化及其病理意义  

Pathological significance of red blood cell volume distribution width in ovarian cancer analyzed by receiver operating characteristic curve

作　　者：唐闻[1] 鞠瑛[1] 沈亚娟[1] 张倡誌 董振芳[1] 王勇[1] 张炳昌[1] Tang Wen Ju Ying Shen Yajuan Zhang Changzhi Dong Zhenfang Wang Yong Zhang Bingchang(Department of Laboratory Medicine, Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, China)

机构地区：[1]山东大学附属省立医院临床医学检验部,济南250021

出　　处：《中国医药》2017年第7期1049-1052,共4页China Medicine

基　　金：国家自然科学基金（81000731）;山东省卫生和计划生育委员会优秀中青年科学家科研奖励基金（BS2010YY045）

摘　　要：目的 探讨卵巢癌患者红细胞体积分布宽度（RDW）的变化及临床意义。方法 回顾性分析2015年1月至2016年6月山东大学附属省立医院确诊为卵巢癌的患者182例（卵巢癌组），随机选择同期来本院体检的健康志愿者418例为正常对照组。检测并比较所有受试者的红细胞体积分布宽度（RDW）及卵巢癌患者的癌胚抗原、癌抗原19-9（CA19-9）、CA125、CA153、CA724水平。采用受试者工作特征曲线（ROC曲线）分析评价RDW对卵巢癌的诊断价值。结果 卵巢癌组RDW明显高于正常对照组［12.80%（12.40%，13.30%）比12.60%（12.30%，13.00%）］，差异有统计学意义（P＝0.042）。ROC曲线下面积为0.551，RDW诊断卵巢癌灵敏度为15.40%，特异度为96.80%（P＜0.05）。根据ROC曲线计算最佳截点为13.75%，以此截点为界可分为高RDW组（RDW≥13.75%，27例）和低RDW组（RDW＜13.75%，155例）。高RDW组CA125水平明显高于低RDW组［509.90（147.30,1 277.00）kU/L比119.00（42.23,765.30）kU/L］，差异有统计学意义（P＝0.007）。高RDW组和低RDW组在肿瘤直径及淋巴结转移方面差异有统计学意义（P＜0.05）。结论 卵巢癌患者RDW升高，并且与患者的肿瘤标志物CA125、肿瘤大小及淋巴结转移存在关系。Objective To explore the clinical significance of red blood cell volume distribution width（RDW） in patients with ovarian cancer. Methods One hundred and eighty-two patients with ovarian cancer（ovarian cancer group） and 418 healthy people（control group） in Shandong Provincial Hospital Affiliated to Shandong University from January 2015 to June 2016 were retrospectively analyzed. RDW, carcinoembryonic antigen（CEA）, carcinoma antigen 19-9（CA19-9）, CA125, CA153 and CA724 were tested. The diagnostic value of RDW in ovarian cancer was evaluated by receiver operating characteristic curve（ROC curve）. Results The value of RDW in ovarian cancer group was significantly higher than that in control group[12.80%（12.40%, 13.30%） vs 12.60%（12.30%, 13.00%）]（P=0.042）. The area under ROC curve was 0.551; the sensitivity was 15.40% and the specificity was 96.80% of RDW in diagnosis of ovarian cancer （P〈0.05）. According to the optimum cutpoint of ROC curve（13.75%）, ovarian cancer patients were divided into high RDW group（RDW≥13.75%, 27 cases） and low RDW group（RDW〈13.75%, 155 cases）. The value of CA125 in high RDW group was significantly higher than that in low RDW group[509.90（147.30,1 277.00）kU/L vs 119.00（42.23,765.30）kU/L]（P=0.007）. Tumor diameter and lymphatic metastasis also showed significant differences between groups（P〈0.05）. Conclusion RDW increases in patients with ovarian cancer and it is related with tumor marker CA125, tumor size and lymphatic metastasis.

关 键 词：卵巢肿瘤 红细胞体积分布宽度 糖类抗原125 受试者工作特征曲线 

分 类 号：R737.31[医药卫生—肿瘤]