子宫内膜细胞学联合血清HE4、CA724检测对早期子宫内膜癌诊断价值  

Value of endometrial cytology test combined with serum HE4 and CA724 levels for early diagnosing endometrial cancer

作　　者：陈玲 黄杭珍 CHEN Ling;HUANG Hangzhen(Changxing County Maternal and Child Health Care Hospital,Zhejiang Province,31310)

机构地区：[1]浙江省长兴县妇幼保健院,313100

出　　处：《中国计划生育学杂志》2022年第9期2150-2153,2158,共5页Chinese Journal of Family Planning

摘　　要：目的:探究子宫内膜细胞学(ECT)联合血清人附睾上皮分泌蛋白4(HE4)、糖类抗原724(CA724)检测对子宫内膜癌早期诊断价值。方法:选取2019年3月-2021年3月本院收诊的子宫异常流血或内膜增厚或宫腔有异常回声的80例临床资料,分别采用ECT和诊断性刮宫术细胞学检查;采用酶联免疫吸附法检测血清HE4、CA724水平;评估血清HE4、CA724及ECT诊断子宫内膜癌价值。结果:ECT和诊断性刮宫术两种检查方法取材满意度无差异(P>0.05),但诊断性刮宫患者的疼痛程度、出血量更大(P<0.05)。80例中,以77例ECT取材满意样本为研究目标,ECT检查结果为子宫内膜癌44例、非癌33例,诊断性刮宫结果为子宫内膜癌43例、非癌34例。子宫内膜癌患者血清HE4、CA724水平均非癌患者(P<0.05)。受术者工作特征曲线分析显示,血清HE4、CA724诊断子宫内膜癌的曲线下面积(AUC)分别为0.817、0.844,截断值分别为74.442 pmol/L、8.506 U/ml。ECT联合血清HE4、CA724检测灵敏度(90.7%)、特异度(91.2%)、准确度(90.9%)均最高,误诊率(8.8%)、漏诊率(9.3%)最低(P<0.05)。结论:ECT检查较诊断性刮宫检查患者疼痛轻、出血量少,子宫内膜癌患者血清HE4、CA724水平异常升高,ECT、HE4、CA7243者联合检测诊断子宫内膜癌效能显著提高,可作为筛查子宫内膜癌的辅助方法。Objective:To explore the value of endometrial cytology test(ECT)combined with serum human epididymal epithelial secretory protein 4(HE4)and carbohydrate antigen 724(CA724)levels for early diagnosing endometrial cancer.Methods:The clinic data of 80 patients with abnormal uterine bleeding,endometrial thickening,or abnormal echo in the uterine cavity by ultrasound examination From March 2019 to March 2021 were selected in this research.Pathological examination of these patients was carried out after ECT and diagnostic curettage.Enzyme-linked immunosorbent assay(ELISA)was performed to detect the levels of serum HE4 and CA724 of these patients.The diagnostic values of the serum HE4 and CA724 levels,and ECT for diagnosing endometrial cancer were evaluated.Results:There was no significant difference in the satisfaction of the samples of the patients between ECT and diagnostic curettage(P>0.05),but the degree of pain and the blood loss of the patients with diagnostic curettage were significant higher(P<0.05).Among the 80 patients,77 patients with the satisfactory samples for ECT were taken as the research target,there were 44 cases with endometrial cancer and 33 cases without endometrial cancer by ECT examination,and there were 43 cases with endometrial cancer and 34 cases without endometrial cancer by diagnostic curettage.The levels of serum HE4 and CA724 of the patients with endometrial cancer were significantly higher than those of the patients without endometrial cancer(P<0.05).The receiver operating characteristic curve analysis showed that the area under the curve(AUC)of the serum HE4 and CA724 levels for diagnosing endometrial cancer were 0.817 and 0.844,and the cut-off values of which were 74.442 pmol/L and 8.506 U/ml.The sensitivity,the specificity,and the accuracy of ECT combined with the serum HE4 and CA724 levels for diagnosing endometrial cancer were 90.7%,91.2%,and 90.9%,respectively,and which were the highest.And the misdiagnosis rate and the missed diagnosis rate of ECT combined with the serum HE4 and CA7

关 键 词：子宫内膜癌 细胞学 血清学 人附睾上皮分泌蛋白4 糖类抗原724 诊断效能 

分 类 号：R737.33[医药卫生—肿瘤]