CA199、Inhibin A及Vimentin联合检测在卵巢癌鉴别诊断中的应用  

Application of combination detection of CA199,Inhibin A and Vimentin in differential diagnosis of ovarian cancer

作　　者：王敏[1] 方月兰[1] 胡军武[1] 江小玲[2] WANG Min;FANG Yuelan;HU Junwu(Department of Gynaecology,Suqian People’s Hospital,Jiangsu,Suqian 223800,China)

机构地区：[1]江苏省宿迁市人民医院妇科,223800 [2]江苏省宿迁市人民医院病理科,223800

出　　处：《河北医药》2019年第20期3155-3158,共4页Hebei Medical Journal

摘　　要：目的探讨CA199、Inhibin A及Vimentin联合检测在卵巢癌鉴别诊断中的价值。方法选取123例疑似卵巢癌患者,其中经术后病理确诊为卵巢癌患者74例,卵巢良性病变患者49例。采用酶联免疫吸附法(ELISA)检测所有受试者血清中CA199表达水平,免疫组织化学法检测肿瘤组织中Inhibin A及Vimentin表达情况。以病理诊断结果为金标准,分析各指标单项以及联合诊断卵巢癌效能。结合Logistic回归分析,绘制ROC曲线并计算及比较曲线下面积(AUC)评价各指标单项及联合检测的诊断价值。结果卵巢癌患者血清中CA199水平较卵巢良性病变患者升高(P<0.05),组织中Inhibin A和vimentin阳性表达率较较卵巢良性病变患者升高(P<0.05)。三项联合诊断卵巢癌的灵敏度为93.24%,特异度为87.76%,准确度为91.06%。三项联合检测卵巢癌的灵敏度与准确度均显著高于各单项指标诊断,差异有统计学意义(P<0.05);特异度也均高于各单项指标诊断,但与Vimentin单项诊断相比差异无统计学意义(P>0.05)。CA199、Inhibin A和vimentin单项检测卵巢癌时ROC曲线下面积(AUC)分别为0.782、0.752、0.775,明显低于三者联合检测的ROC曲线下面积0.877(P<0.05)。Logistic回归分析结果显示,CA199、Inhibin A和vimentin均是卵巢癌的独立影响因素。结论联合检测CA199、Inhibin A及vimentin可提高卵巢癌诊断的敏感度及特异性,对卵巢癌诊断有较好的应用价值。Objective To investigate the application value of combination detection of CA199,Inhibin A and Vimentin in differential diagnosis of ovarian cancer.Methods A total of 123 patients with suspected ovarian cancer were enrolled in the study,including 74 patients with ovarian cancer and 49 patients with benign ovarian lesions who were diagnosed by postoperative pathological examination.The serum levels of CA199 were detected by enzyme-linked immunosorbent assay(ELISA).The expression levels of Inhibin A and Vimentin in tumor tissues were detected by immunohistochemistry.The pathological diagnosis results were used as the gold standard,and the diagnostic efficiency of each index and the combination diagnosis of ovarian cancer was analyzed.Combining with logistic regression analysis,the ROC curve was drawn and the area under the curve(AUC)was calculated to evaluate the diagnostic value of each index and combination detection.Results The serum levels of CA199 in patients with ovarian cancer were significantly higher than those in patients with ovarian benign lesions(P<0.05),moreover,the positive expression rates of Inhibin A and vimentin in tissues of patients with ovarian cancer were significantly higher than those in patients with ovarian benign lesions(P<0.05).The sensitivity,specificity and accuracy of combination detection of the three indexes were 93.24%,87.76%,91.06%,respectively,which were significantly higher than those by simple index detection(P<0.05),however,there was no significant difference in the specificity by simple Vimentin detection(P>0.05).The area under the ROC curve(AUC)of CA199,Inhibin A and vimentin in detection of ovarian cancer was 0.782,0.752 and 0.775,respectively,which was significantly lower than that(0.877)by combination detection(P<0.05).Logistic regression analysis showed that CA199,Inhibin A and vimentin were independent factors of ovarian cancer.Conclusion The combination detection of CA199,Inhibin A and vimentin can improve the sensitivity and specificity in diagnosis of ovarian cancer

关 键 词：卵巢癌 CA199 INHIBIN A VIMENTIN 诊断 

分 类 号：R737.31[医药卫生—肿瘤]