血清微RNA-191、细胞角蛋白19片段抗原21-1、糖类抗原72-4水平对卵巢良、恶性肿瘤的鉴别诊断价值  

The value of serum microRNA-191,cytokeratin 19 fragment antigen 21-1 and carbohydrate antigen 72-4 in the differential diagnosis of benign and malignant ovarian tumors

作　　者：吕娜[1] Lyu Na(Department of Gynecology,Beijing Obstetrics and Gynecology Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京妇产医院妇科,北京100020

出　　处：《中国医学前沿杂志（电子版）》2020年第12期121-125,共5页Chinese Journal of the Frontiers of Medical Science(Electronic Version)

摘　　要：目的探究血清微RNA-191(microRNA-191,miR-191)、细胞角蛋白19片段抗原21-1(cytokeratin 19 fragments antigen 21-1,CYFRA21-1)、糖类抗原72-4(carbohydrate antigen 72-4,CA72-4)水平对卵巢良、恶性肿瘤的鉴别诊断价值。方法将2017年6月至2019年6月首都医科大学附属北京妇产医院收治的156例卵巢恶性肿瘤患者和121例卵巢良性肿瘤患者分别纳入恶性组和良性组,另选取该院同期体检健康者纳入健康组。采用定量反转录聚合酶链反应技术检测受试者血清miR-191水平,采用电化学发光免疫法检测受试者血清CYFRA21-1、CA72-4水平。采用接受者操作特征曲线分析血清miR-191、CYFRA21-1、CA72-4水平对卵巢恶性肿瘤的诊断价值。结果良性组与恶性组患者血清miR-191、CYFRA21-1、CA72-4水平均显著高于健康组(均P<0.05)。恶性组患者血清miR-191、CYFRA21-1、CA72-4水平均显著高于良性组(均P<0.05)。临床分期Ⅲ~Ⅳ期、淋巴结转移患者血清miR-191、CYFRA21-1、CA72-4水平均显著高于Ⅰ~Ⅱ期、无淋巴结转移患者(均P<0.05)。高、中、低分化患者血清miR-191、CYFRA21-1、CA72-4水平依次显著升高(均P<0.05)。血清miR-191、CYFRA21-1、CA72-4预测卵巢恶性肿瘤的曲线下面积(area under the curve,AUC)分别为0.765、0.807、0.770,均明显低于三者联合检测的AUC(0.854)(Z=2.790、2.743、2.256,均P<0.05),且三者联合检测的灵敏度最高。结论卵巢恶性肿瘤患者血清miR-191、CYFRA21-1、CA72-4表达水平上调,均与临床分期、肿瘤分化程度和淋巴结转移有关,三者联合检测对卵巢良、恶性肿瘤的鉴别价值较高,有助于提高临床对卵巢恶性肿瘤的诊断准确性。Objective To explore the value of serum microRNA-191(miR-191),cytokeratin 19 fragment antigen 21-1(CYFRA21-1)and carbohydrate antigen 72-4(CA72-4)levels in the differential diagnosis of ovarian benign and malignant tumors.Method From June 2017 to June 2019,156 patients with malignant tumor and 121 patients with ovarian benign tumor were selected as malignant group and benign group respectively,in addition,the healthy persons in the same period were selected as healthy group.The level of serum miR-191 was detected by quantitative reverse transcriptase-mediated polymerase chain reaction,and the levels of serum CYFRA21-1 and CA72-4 were detected by electrochemiluminescence immunoassay.In addition,the diagnostic value of serum miR-191,CYFRA21-1 and CA72-4 levels in ovarian malignant cancer were analyzed by receiver operating characteristic curve.Result The levels of miR-191,CYFRA21-1 and CA72-4 in benign group and malignant group were significantly higher than those in healthy group(all P<0.05),the levels of miR-191,CYFRA21-1 and CA72-4 in malignant group were significantly higher than those in benign group(all P<0.05).The levels of serum miR-191,CYFRA21-1 and CA72-4 in patients with clinical stagingⅢ~Ⅳand lymph node metastasis were significantly higher than those in patients with clinical stagingⅠ~Ⅱand non lymph node metastasis(all P<0.05).The levels of serum miR-191,CYFRA21-1 and CA72-4 in patients with high,middle and low differentiation were significantly increased in turn(all P<0.05).The area under the curve(AUC)of serum miR-191,CYFRA21-1 and CA72-4 in the prediction of ovarian cancer were 0.765,0.807 and 0.770 respectively,which were significantly lower than 0.854 of the three combined detection(Z=2.790,2.743,2.256,all P<0.05),and the sensitivity of the combined detection was the highest.Conclusion The levels of serum miR-191,CYFRA21-1 and CA72-4 in patients with ovarian cancer are up-regulated,and all of them are related to clinical staging,differentiation degree and lymph node metastasis,in addition,t

关 键 词：卵巢肿瘤 微RNA-191 细胞角蛋白19片段抗原21-1 糖类抗原72-4 鉴别诊断 

分 类 号：R737.31[医药卫生—肿瘤]