绝经后阴道出血伴发宫颈癌的危险因素及血清肿瘤标记物的预测价值  

Risk factors of cervical cancer in patients with postmenopausal vaginal bleeding and the monitoring value of serum tumor markers

作　　者：祁彦萍[1] 王英[1] 杨建敏[1] Qi Yanping;Wang Ying;Yang Jianmin(Department of Obstetrics and Gynecology,Nanyang Central Hospital,Nanyang 473000,China)

机构地区：[1]河南省南阳市中心医院妇产科,473000

出　　处：《中国实用医刊》2020年第20期39-42,共4页Chinese Journal of Practical Medicine

摘　　要：目的探讨绝经后阴道出血伴宫颈癌的危险因素及血清肿瘤标记物的预测价值。方法抽取2012年2月至2017年2月南阳市中心医院收治的150例绝经后阴道出血患者进行研究,其中宫颈癌78例,良性宫颈瘤72例。观察两组临床特征并进行比较,利用COX回归性分析明确绝经后阴道出血患者发生宫颈癌的独立危险因素,采用受试者工作特征曲线(ROC)分析相关血清肿瘤标记物对宫颈癌的预测价值。结果宫颈癌组绝经至出血时间≥5年、子宫内膜厚度≥5 mm占比以及血清低氧诱导因子-1α(HIF-1α)、鳞状细胞相关抗原(SCC-Ag)、铁蛋白(SF)水平均高于良性宫颈瘤组,组间比较差异有统计学意义(P<0.05)。血清HIF-1α预测绝经后伴宫颈癌的曲线下面积为0.981,敏感度、特异度分别为89.7%、88.9%;血清SCC-Ag预测的曲线下面积为0.934,敏感度、特异度分别为93.6%、93.1%;血清SF预测的曲线下面积为0.886,敏感度、特异度分别为88.5%、84.7%。经多因素回归性分析发现,血清HIF-1α、SCC-Ag、SF、子宫内膜厚度与绝经后阴道出血宫颈癌发生呈正相关(P<0.05)。结论血清HIF-1α、SCC-Ag、SF监测对预测绝经后阴道出血伴宫颈癌具有较高价值,另外子宫内膜厚度同为宫颈癌危险因素,需引起临床重视。Objective To explore the risk factors of cervical cancer in patients with postmenopausal vaginal bleeding and the predictive value of serum tumor markers.Methods A total of 150 cases of postmenopausal vaginal bleeding in Nanyang Central Hospital from February 2012 to February 2017 were included in the study,including 78 cases of cervical cancer and 72 cases of benign cervical tumor.The independent risk factors of cervical cancer in patients with postmenopausal vaginal bleeding were identified by Cox regression analysis.The predictive value of serum tumor markers for cervical cancer was analyzed by receiver operating characteristic curve(ROC).Results Cervical cancer group of postmenopausal bleeding time to more than 5 years,the endometrial thickness of 5 mm ratio and serum serum hypoxia inducible factor-1α(HIF-1α),squamous cell associated antigen(SCC-Ag),serum ferritin(SF)levels were higher than those of benign cervical tumor group,there were significant differences between the groups(P<0.05).The serum levels of HIF-1αprediction area associated with cervical cancer in postmenopausal women under the curve was 0.981,sensitivity and specificity were respectively 89.7%and 88.9%;the area under the curve of serum SCC-Ag prediction was 0.934,sensitivity and specificity were respectively 93.6%and 93.1%;the area under the curve of serum SF prediction was 0.886,sensitivity and specificity were 88.5%and 84.7%respectively.Multivariate regression analysis showed that serum HIF-1α,SCC-Ag,SF and endometrial thickness were positively correlated with postmenopausal vaginal bleeding and cervical cancer(P<0.05).Conclusions Serum HIF-1α,SCC Ag,SF monitoring has a high value in predicting postmenopausal vaginal bleeding with cervical cancer.In addition,endometrial thickness is a risk factor for cervical cancer,which should be paid attention to clinically.

关 键 词：宫颈癌 绝经后阴道出血 危险因素 肿瘤标记物 

分 类 号：R737.33[医药卫生—肿瘤]