炎症指标及肿瘤标志物在子宫内膜异位症中的意义研究  

Significances of Inflammation Indexes and TumorMarkers in Endometriosis

作　　者：高菲[1] 魏佳玲[1] 陈婷 杨辰[2] GAO Fei;WEI Jialing;CHEN Ting;YANG Chen(Suzhou Municipal Hospital,Affiliated to Nanjing Medical University,Suzhou 215000,China)

机构地区：[1]南京医科大学附属苏州医院苏州市立医院,江苏苏州215000 [2]南京医科大学附属苏州医院苏州市立医院医学检验科,江苏苏州215000

出　　处：《标记免疫分析与临床》2021年第7期1126-1130,共5页Labeled Immunoassays and Clinical Medicine

基　　金：苏州市科教兴卫青年科技项目(编号:Kjxw2018026);苏州市科技发展计划医疗卫生应用基础研究(编号:SYS2020173)。

摘　　要：目的分析炎症指标及肿瘤标志物在子宫内膜异位症患者与健康人群中的差异,探讨其对子宫内膜异位症的诊断价值,建立更高效能的联合诊断模型。方法回顾分析子宫内膜异位症患者及健康人群外周血炎症指标(NEUT%、LYM%、MXD%、EO%、NEUT#、LYM#、MXD#、PLT、NLR、MLR、PLR、ELR、SⅡ、SIRI)和肿瘤标志物(AFP、CA19-9、CA125、CA15-3、HE4、ROMA)的水平差异,通过二元Logistic回归分析筛选与子宫内膜异位症发病相关的危险因素,并构建联合诊断模型。绘制ROC曲线,并计算AUC,分析不同诊断指标的诊断效能。结果子宫内膜异位症患者EO%(P=0.030),LYM#(P<0.001)低于健康对照组,PLR(P=0.024),CA19-9(P<0.001),CA125(P<0.001),HE4(P<0.001),ROMA(P<0.001)高于健康对照组。调整了PLR、CA19-9、ROMA的影响后,发现EO%、LYM#、CA125、HE4与子宫内膜异位症的发病显著相关。通过绘制ROC曲线分析发现,EO%、LYM#、CA125、HE4联合诊断子宫内膜异位症的AUC(0.940)及灵敏度(90.10%)均大于各指标单独诊断,且具有较高的特异性(86.25%),对于子宫内膜异位症具有更好的诊断价值。结论EO%、LYM#、CA125、HE4联合诊断模型有较好的诊断效能,可能为临床早期无创诊断子宫内膜异位症提供新思路。Objective To analyze the differences of the inflammation indexes and the tumor biomarkers between endometriosis patients and healthy people,also to explore their diagnostic values in endometriosis patients,and so as to establish a more efficient combined diagnostic model.Methods We retrospectively analyzed the differences of NEUT%,LYM%,MXD%,EO%,NEUT#,LYM#,MXD#,PLT,NLR,MLR,PLR,ELR,SⅡ,SIRI,AFP,CA19-9,CA125,CA15-3,HE4 and ROMA between endometriosis patients and healthy people.Binary logistic regression analysis was conducted to identify the risk factors of endometriosis and to establish a combined diagnostic model.We plotted the ROC curve and calculated AUC to evaluate the diagnostic efficiency of different diagnostic indexes.Results Compared with patients in the control group,patients in the endometriosis group had significantly lower EO%(P=0.030)and LYM#(P<0.001),while significantly higher PLR(P=0.024),CA19-9(P<0.001),CA125(P<0.001),HE4(P<0.001)and ROMA(P<0.001).After adjustment for PLR,CA19-9 and ROMA,EO%,LYM#,CA125 and HE4 were significantly correlated to the incidence of endometriosis.ROC curve showed that the combination of EO%,LYM#,CA125 and HE4 reached the sensitivity of 90.10%,the specificity of 86.25%and the AUC of 0.940,which was significantly higher than that of the individual index tests.Conclusion Combined diagnostic model of EO%,LYM#,CA125 and HE4 exhibits an ideal diagnostic efficacy for endometriosis,and may provide a new tool for the early non-invasive diagnosis for endometriosis.

关 键 词：子宫内膜异位症 联合诊断 特异性 灵敏度 

分 类 号：R711.71[医药卫生—妇产科学]