肿瘤分子标记物联合动态检测在卵巢上皮癌诊断和预后评估的价值  

The value of combined dynamic detection of tumor molecular markers in the diagnosis and prognosis evaluation of epithelial ovarian cancer

作　　者：吕东梅 徐风亮[2] 陈玉[2] LüDongmei

机构地区：[1]日照心脏病医院,山东日照276800 [2]日照市人民医院,山东日照276826

出　　处：《中医临床研究》2021年第20期14-18,共5页Clinical Journal Of Chinese Medicine

摘　　要：目的:分析血清肿瘤分子标记物糖类抗原125、人附睾蛋白4及癌胚抗原在卵巢上皮癌血清中的表达,探讨其联合动态检测在卵巢癌诊断和预后评估的价值。方法:选取122例卵巢上皮癌患者、50例卵巢良性病变患者及50例健康体检者为研究对象,采用电化学发光法及酶联免疫法检测三组人群血清糖类抗原125、癌胚抗原、人附睾蛋白4水平,卡普兰-梅尔分析法及对数秩和检验生存分析评估预后,绘制受试者工作特征曲线确定血清糖类抗原125、癌胚抗原、人附睾蛋白4诊断卵巢癌的最佳临界值,比较单项及联合检测诊断卵巢癌的价值。结果:卵巢癌患者血清糖类抗原125、人附睾蛋白4、癌胚抗原水平显著高于良性病变组和正常对照组(P<0.01),良性对照组与健康对照组比较差异无统计学意义(P>0.05);卵巢癌临床高分期(Ⅲ、Ⅳ期)组、低分化组、合并腹水组、转移组、复发组、治疗前血清糖类抗原125、人附睾蛋白4、癌胚抗原水平显著高于临床低分期(Ⅰ、Ⅱ期)组、高中分化组、无腹水组、无转移组、无复发组、治疗后(均P<0.05);糖类抗原125、人附睾蛋白4及癌胚抗原低水平表达组无事件(无复发、转移、死亡)生存率显著高于高水平表达组(χ^(2)=16.487、50.737、16.309,P=0.000、0.000、0.000),P<0.01;糖类抗原125、人附睾蛋白4、癌胚抗原三项联合检测诊断卵巢上皮癌的敏感性、准确性、阴性预测值与各单项检测比较显著提高(P<0.05)。结论:糖类抗原125、人附睾蛋白4、癌胚抗原与卵巢上皮癌发生发展密切相关,联合检测有利于卵巢上皮癌早期诊断、监控病情及预后评估。Objective:To analyze the expression of serum tumor molecular markers carbohydrate antigen 125,human epididymal protein 4 and carcinoembryonic antigen in serum of ovarian epithelial cancer,and to explore their combined dynamic detection in the diagnosis of ovarian cancer,and the value of prognostic assessment.Methods:122 patients with epithelial ovarian cancer,50 patients with benign ovarian lesions and 50 healthy subjects were selected as the research objects.electrochemiluminescence and enzyme-linked immunoassay were used to detect the serum levels of CA125,CEA,and HE4 in the three groups.Kaplan-Meier method and Log-rank test survival analysis to evaluate prognosis,draw receiver operating characteristic curve to determine the best cut-off value of serum CA125,CEA,HE4 for the diagnosis of ovarian cancer,and compare single and combined tests for diagnosis of ovarian cancer the value.Results:Serum levels of CA125,HE4,and CEA in patients with ovarian cancer were significantly higher than those in the benign lesion group and the normal control group(P<0.01),and there was no statistical difference between the benign control group and the healthy control group(P>0.05);clinical high-stage(Ⅲ,Ⅳ)ovarian cancer group,poorly differentiated group,combined ascites group,metastasis group,recurrence group,serum CA125,HE4,CEA levels before treatment were significantly higher than clinical low-stage(Ⅰ,Ⅱ)group,highly differentiated group,no ascites group,no metastasis group,no recurrence group,after treatment(all P<0.05),event-free(no recurrence,metastasis,death)survival rate in the CA125,HE4 and CEA low-level expression group significantly higher than the high-level expression group(χ^(2)=16.487,50.737,16.309,P=0.000,0.000,0.000),P<0.01,the sensitivity and accuracy of the combined detection of CA125,HE4 and CEA in the diagnosis of epithelial ovarian cancer;the sex and negative predictive values were significantly higher than those in the individual tests(P<0.05).Conclusion:CA125,HE4,CEA are closely related to the occurren

关 键 词：卵巢上皮癌 糖类抗原125 人附睾蛋白4 癌胚抗原 

分 类 号：R246.5[医药卫生—针灸推拿学]