卵巢癌患者血清甲胎蛋白、人绒毛膜促性腺激素、糖类抗原72-4水平预测淋巴结转移的受试者工作特征曲线分析  

Receiver operating characteristic curve analysis of serum alpha fetoprotein,human chorionic gonadotropin and carbohydrate antigen 72-4 for predicting lymph node metastasis in patients with ovarian cancer

作　　者：刘亚娟[1] 韩瑜[2] 郑艳[3] LIU Yajuan;HAN Yu;ZHENG Yan(Clinical Laboratory,2Department of Oncology,3Department of Gynaecology,Jiyuan People’s Hospital,Jiyuan 459000,He’nan,China)

机构地区：[1]济源市人民医院检验科,河南济源4590000 [2]济源市人民医院肿瘤科,河南济源4590000 [3]济源市人民医院妇科,河南济源4590000

出　　处：《癌症进展》2021年第3期294-297,共4页Oncology Progress

摘　　要：目的应用受试者工作特征(ROC)曲线探究卵巢癌患者血清甲胎蛋白(AFP)、人绒毛膜促性腺激素(HCG)、糖类抗原72-4(CA72-4)水平对患者淋巴结转移的预测价值。方法将157例卵巢癌患者按淋巴结转移情况分为转移组(n=67)及未转移组(n=90),同时收集同期收治的80例卵巢良性肿瘤患者作为对照组。比较3组患者血清中AFP、HCG以及CA72-4水平,不同特征转移组患者血清AFP、HCG以及CA72-4水平,分析血清AFP、HCG以及CA72-4水平对淋巴结转移的预测价值,AFP、HCG以及CA72-4水平之间的相关性。结果转移组患者血清AFP、HCG以及CA72-4水平均高于未转移组及对照组,未转移组患者血清AFP、HCG以及CA72-4水平均高于对照组,差异均有统计学意义(P﹤0.05)。肿瘤直径﹥5 cm、临床分期为Ⅲ+Ⅳ期、中低分化患者血清AFP、HCG、CA72-4水平分别高于肿瘤直径≤5 cm、临床分期为Ⅰ+Ⅱ期、高分化患者,差异均有统计学意义(P﹤0.05)。ROC曲线分析结果显示,单项检测中HCG的曲线下面积(AUC)最大,两项指标联合检测中CA72-4+HCG的AUC最大,3项指标联合检测的AUC大于单一指标检测与两项指标联合检测。AFP与HCG、CA72-4水平均无相关性(r=-0.122、0.057,P﹥0.05),HCG与CA72-4水平呈正相关(r=0.498,P﹤0.05)。结论AFP、HCG以及CA72-4可以反映卵巢癌患者淋巴结转移情况,三项指标联合检测可以有效提高对淋巴结转移的预测价值,为其治疗提供有力参考依据。Objective To explore the predictive value of serum alpha fetoprotein(AFP), human chorionic gonadotropin(HCG) and carbohydrate antigen 72-4(CA72-4) levels in lymph node metastasis of ovarian cancer by receiver operating characteristic(ROC) curves. Method A total of 157 patients with ovarian cancer were divided into metastasis group(n=67) and non-metastasis group(n=90) according to the presence or absence of lymph node metastasis. Meanwhile, 80 patients with benign ovarian tumors were enrolled as control group. The levels of serum AFP, HCG and CA72-4 in the three groups were compared. The predictive value of serum AFP, HCG and CA72-4 levels in lymph node metastasis, and correlations among the three indexes were analyzed. Result The serum levels of AFP, HCG and CA72-4 in the metastasis group were higher than those in the non-metastasis group and the control group. The serum levels of AFP, HCG and CA72-4 in the non-metastasis group were higher than those in the control group, and the differences were statistically significant(P<0.05). Serum AFP, HCG and CA72-4 levels were higher in patients with tumor diameter>5 cm, clinical stage Ⅲ+Ⅳ, moderate and low differentiation than in those with tumor diameter≤5 cm, clinical stage Ⅰ+Ⅱ and high differentiation(P<0.05). The results of ROC curve analysis showed that for detection of single index, the area under the curve(AUC) of HCG was the largest, for detection of two indexes, the AUC of CA72-4 combined with HCG was the largest,and the AUC of combined detection of the three indexes was greater than that of single index and combined detection of any two indexes. There was no significant correlation between AFP and HCG, CA72-4 levels(r=-0.122, 0.057, P>0.05),while there was positive correlation between HCG and CA72-4 levels(r=0.498, P<0.05). Conclusion AFP, HCG and CA72-4 can reflect lymph node metastasis in patients with ovarian cancer. The combination of the three indexes can effectively improve the predictive value in lymph node metastasis, and provide a strong basi

关 键 词：卵巢癌 血清甲胎蛋白 人绒毛促性腺激素 糖类抗原72-4 淋巴结转移 受试者工作特征曲线 

分 类 号：R737.31[医药卫生—肿瘤]