血清细胞角蛋白19片段、α-烯醇化酶检测在子宫内膜癌诊断及病情严重程度评估中的价值  

Value of serum cytokeratin 19 fragment andα-enolase detection in diagnosis and severity assessment of endometrial carcinoma

作　　者：都燕 代佳 DU Yan;DAI Jia(Affiliated Hospital of Yan’an University,Yan’an 716000,China)

机构地区：[1]延安大学附属医院,陕西延安716000 [2]陕西省肿瘤医院,陕西西安710061

出　　处：《陕西医学杂志》2023年第2期212-216,共5页Shaanxi Medical Journal

基　　金：陕西省中医药管理局科研项目(2021-ZZ-LC023)。

摘　　要：目的:探讨血清细胞角蛋白19片段(CYFRA21-1)、α-烯醇化酶(ENO1)检测对子宫内膜癌的诊断价值以及对患者病情严重程度的评估作用。方法:选择83例子宫内膜癌患者、95例良性子宫内膜疾病患者和100例健康女性作为研究对象。采用酶联免疫吸附法检测血清CYFRA21-1、ENO1水平,比较各组血清CYFRA21-1、ENO1水平差异。分析血清CYFRA21-1、ENO1水平与子宫内膜癌患者病理特征的关系。采用受试者工作特征(ROC)曲线分析血清CYFRA21-1、ENO1水平诊断子宫内膜癌的效能。结果:子宫内膜癌组血清CYFRA21-1、ENO1水平高于良性子宫内膜疾病组和对照组,良性子宫内膜疾病组血清CYFRA21-1、ENO1水平高于对照组(均P<0.05)。透明细胞癌患者血清CYFRA21-1、ENO1水平高于其他三种类型,鳞癌患者血清CYFRA21-1、ENO1水平高于腺癌和混合性癌(均P<0.05)。Ⅲ期和Ⅳ期患者血清CYFRA21-1、ENO1水平均高于Ⅰ期和Ⅱ期患者(均P<0.05);Ⅱ期患者血清CYFRA21-1、ENO1水平高于Ⅰ期患者(均P<0.05)。不同分化程度患者血清CYFRA21-1、ENO1水平两两比较均有统计学差异(均P<0.05),高分化患者血清CYFRA21-1、ENO1水平最高。肌层浸润≥1/2、发生淋巴结转移的患者血清CYFRA21-1、ENO1水平高于肌层浸润<1/2、未发生淋巴结转移的患者(P<0.05)。复发组和术后1年内死亡的子宫内膜癌患者血清CYFRA21-1、ENO1水平均高于未复发组和未死亡患者(均P<0.05)。血清CYFRA21-1诊断子宫内膜癌的AUC为0.939,以≥4.8 ng/ml作为诊断阈值,其敏感度、特异度和约登指数分别为95.18%、75.90%和71.08%;血清ENO1诊断子宫内膜癌的AUC为0.879,以≥482.5 pg/ml作为诊断阈值,其敏感度、特异度和约登指数分别为85.54%、76.92%和62.47%。结论:血清CYFRA21-1、ENO1水平提高与子宫内膜癌多种病理特征相关,术后复发和1年内死亡患者血清CYFRA21-1、ENO1水平增加尤为明显,通过检测这两个指标可辅助诊断子宫�Objective:To investigate the diagnostic value of serum cytokeratin 19 fragment(CYFRA21-1)and alpha-enolase(ENO1)detection in endometrial carcinoma and their roles in evaluating the severity of patients’condition.Methods:A total of 83 patients with endometrial carcinoma,95 patients with benign endometrial disease and 100 healthy women were selected as the subjects.The levels of serum CYFRA21-1 and ENO1 were detected by enzyme-linked immunosorbent assay,and the differences of serum CYFRA21-1 and ENO1 levels among the groups were compared.The relationship between serum CYFRA21-1,ENO1 levels and pathological characteristics of endometrial cancer patients was analyzed.ROC curve was used to analyze the efficacy of serum CYFRA21-1 and ENO1 levels in the diagnosis of endometrial carcinoma.Results:The levels of serum CYFRA21-1 and ENO1 in endometrial carcinoma group were significantly higher than those in benign endometrial disease group and control group,and the levels of serum CYFRA21-1 and ENO1 in benign endometrial disease group were higher than those in control group(all P<0.05).The levels of serum CYFRA21-1 and ENO1 in patients with clear cell carcinoma were higher than those of the other three types,and the levels of serum CYFRA21-1 and ENO1 in patients with squamous cell carcinoma were higher than those of adenocarcinoma and mixed carcinoma(all P<0.05).The levels of serum CYFRA21-1 and ENO1 in patients with stageⅢandⅣwere higher than those in patients with stageⅠandⅡ,and the levels of serum CYFRA21-1 and ENO1 in patients with stageⅡwere higher than those in patients with stageⅠ(all P<0.05).The levels of serum CYFRA21-1 and ENO1 in patients with different degrees of differentiation were different(all P<0.05),and the levels of serum CYFRA21-1 and ENO1 in patients with high differentiation were the highest.The serum CYFRA21-1 and ENO1 levels in patients with myometrial invasion≥1/2 and lymph node metastasis were higher than those in patients with myometrial invasion<1/2 and no lymph node metastasis(al

关 键 词：子宫内膜癌 细胞角蛋白19片段 α-烯醇化酶 病理特征 诊断 病情评估 

分 类 号：R737.33[医药卫生—肿瘤]