血清脂联素、骨桥蛋白和HE4在子宫内膜癌患者中的表达及意义  

Expression and Significance of Serum Adiponectin,Osteopontin and HE4 in Patients with Endometrial Cancer

作　　者：朱玲 吕旺桂[1] 何南[1] ZHU Ling;LYU Wang-gui;HE Nan(Chenzhou First People's Hospital,Hunan Chenzhou 423000)

机构地区：[1]郴州市第一人民医院,湖南郴州423000

出　　处：《深圳中西医结合杂志》2023年第2期8-12,I0002,共6页Shenzhen Journal of Integrated Traditional Chinese and Western Medicine

基　　金：郴州市科学技术局科研项目(ZDYF2020143);郴州市第一人民医院科研项目(N2020–66)。

摘　　要：目的:探讨血清脂联素(APN)、骨桥蛋白(OPN)和人附睾分泌蛋白4(HE4)在子宫内膜癌患者中的表达及意义。方法:选取2019年11月至2022年9月郴州市第一人民医院收治的子宫内膜癌患者62例(子宫内膜癌组),另选取同期50例子宫内膜不典型增生患者(内膜增生组)和50例健康志愿者(正常内膜组)。检测并比较三组血清APN、OPN、HE4水平,采用受试者工作特征(ROC)曲线分析血清APN、OPN、HE4对子宫内膜癌的诊断效能,并采用Spearman相关性分析探讨血清APN、OPN、HE4与临床病理特征的相关性。结果:子宫内膜癌组患者血清APN水平低于内膜增生组和正常内膜组,OPN、HE4水平高于内膜增生组和正常内膜组。国际妇产科联盟(FIGO)分期为Ⅲ期患者血清APN水平低于Ⅱ期和Ⅰ期患者,OPN、HE4水平高于Ⅱ期和Ⅰ期患者;肌层浸润深度≥1/2肌层患者血清APN水平低于<1/2肌层患者,OPN、HE4水平高于<1/2肌层患者;淋巴结转移患者血清APN水平低于无淋巴结转移患者,OPN、HE4水平高于无淋巴结转移患者,差异均具有统计学意义(P<0.05)。ROC曲线分析显示,血清APN、OPN、HE4联合检测诊断子宫内膜癌的曲线下面积为0.936,灵敏度为91.7%,特异度为88.1%,均高于血清APN、OPN、HE4单独检测。Spearman相关性分析显示,血清APN与FIGO分期、肌层浸润深度及淋巴结转移呈负相关;血清OPN、HE4与FIGO分期、肌层浸润深度及淋巴结转移呈正相关。结论:血清APN、OPN、HE4在子宫内膜癌发生、发展中起重要作用,其表达与子宫内膜癌临床分期、肌层浸润深度及淋巴结转移存在明显相关性,且联合检测能提高子宫内膜癌的诊断效能。Objective To investigate the expression and significance of serum adiponectin(APN),osteopontin(OPN)and human epididymis secreted protein 4(HE4)in patients with endometrial cancer.Methods A total of 62 patients with endometrial cancer(endometrial cancer group),50 patients with endometrial dysplasia(endometrial hyperplasia group)and 50 healthy volunteers(normal endometrial group)were selected from Chenzhou First People’s Hospital from November 2019 to September 2022.Serum levels of APN,OPN,HE4 were detected and compared among the three groups.The diagnostic efficacy of serum APN,OPN,HE4in endometrial cancer was analyzed by receiver operating characteristic(ROC)curve,and the correlation between serum APN,OPN,HE4 and clinicopathologic features was analyzed by Spearman correlation analysis.Results The serum levels of APN in endometrial carcinoma group were lower than those in endometrial hyperplasia group and normal endometrial group,while the levels of OPN and HE4 were higher than those in endometrial hyperplasia group and normal endometrial group.FIGO staging showed that the level of serum APN in stageⅢpatients was lower than those in stageⅡand stageⅠpatients,and the levels of OPN and HE4 was higher than those in stageⅡand stageⅠpatients.The APN level in patients with≥1/2 muscle layer infiltration depth was lower than that in<1/2 muscle layer,and the OPN and HE4 levels were higher than those in<1/2 muscle layer.The serum APN level in patients with lymph node metastasis was lower than that in patients without lymph node metastasis,and the levels of OPN and HE4 were higher than those in patients without lymph node metastasis,with statistical significance(P<0.05).ROC curve analysis showed that the area under the curve of serum APN,OPN and HE4 combined detection was 0.936,the sensitivity was 91.7%,and the specificity was 88.1%,all of them were higher than those of serum APN,OPN and HE4 alone.Spearman correlation analysis showed that serum APN was negatively correlated with FIGO stage,depth of muscle infilt

关 键 词：子宫内膜癌 脂联素 骨桥蛋白 人附睾分泌蛋白4 

分 类 号：R737.33[医药卫生—肿瘤]