血清中CA125、HE4及NLR与子宫内膜异位症相关性及其诊断价值探讨  

Correlations between CA125,HE4 and NLR in patients with endometriosis and their clinical values for diagnosis of endometriosis

作　　者：孟骞 顾振鹏[1] 崔金秀[1] 李霞[1] 刘志慧[1] 孙玉洁 Meng Qian;Gu Zhenpeng;Cui Jinxiu(Department of Obstetrics and Gynecology,Hospital Affiliated Binzhou Medical University,Binzhou 256600)

机构地区：[1]滨州医学院附属医院妇产科,滨州256600

出　　处：《现代妇产科进展》2018年第12期918-920,共3页Progress in Obstetrics and Gynecology

摘　　要：目的:探讨子宫内膜异位症(EM)患者血清中糖链抗原125(CA125)、人附睾蛋白4(HE4)及中性粒细胞与淋巴细胞比值(NLR)相关性及其在子宫内膜异位症(EM)临床诊断中的应用价值。方法:回顾分析2016年10月至2018年5月在滨州医学院附属医院妇产科行腹腔镜检查或开腹手术,术后病理结果确诊为EMs的患者127例(内异症组)。同期选取健康女性83例为对照组。收集血清中CA125、HE4及血常规结果,计算中性粒细胞与淋巴细胞比值,分析三项指标相关性。运用受试者工作特征曲线(ROC)分析比较三者对EMs的诊断效能,logistic回归方程分析其单项和联合检测在诊断EMs中的价值。结果:EM组患者的CA125、HE4和NLR水平均高于对照组,血清CA125与HE4、NLR均呈正相关(r=0.405,P=0.000; r=0.191,P=0.005),HE4与NLR无明显相关性(r=0.003,P=0.961),三指标联合回归模型中ROC曲线下面积(AUC)为0.983,均大于各指标单独诊断时的面积(0.981、0.801、0.745),随着EM分期逐渐递进,CA125、HE4和NLR水平均随之增高(P<0.05),但多项logistic回归模型的预测和解释能力一般。结论:CA125、HE4和NLR联合在EM的诊断中具有潜在的应用价值。Objective:To investigate the correlations between carbohydrate antigen 125 and human epididymis protein 4 and neutrophil-to-lymphocyte ratio in patients with endometriosis and their clinical values for diagnosis of endometriosis.Methods:The detection results of CA125,HE4 and NLR in 127 patients with ovarian endometriosis(endometriosis group)in the Affiliated Hospital of Binzhou Medical University and 83 healthy women undergoing the healthy physical examination(control group)were performed the retrospective and statistial analysis.The correlations among these markers were analyzed.Receiver operating characteristic(ROC)curve was generated to analyze the diagnostic values of CA125,HE4 and NLR for endometriosis.The logistic regression model was used to predict the probability of endometriosis by using CA125,HE4 and NLR in combination.Results:The values of CA125,HE4 and NLR were significantly higher in EM group than those in control group.CA125 was positively correlated with HE4 and NLR(r=0.405,P=0.000;r=0.191,P=0.005).HE4 had no obvious correlated with NLR(r=0.003,P=0.961).The AUC value of combined detection for EM was 0.983,was significantly higher than that of any signal factor(0.981、0.801、0.745).CA125,HE4 and NLR were significantly increased as the progress of EM staging,but the interpretative and forecasting ability of the multinomial logistic regression model is unsatisfactory.Conclusion:The logistic regression model of combination of CA125,HE4 and NLR obtained in this study could be used for diagnosis of endometeiosis in the future.

关 键 词：子宫内膜异位症 糖链抗原125 人附睾蛋白4 中性粒细胞与淋巴细胞比值 

分 类 号：R711[医药卫生—妇产科学]