上皮性卵巢癌血清中肿瘤标志物水平及其临床意义  

Serum levels of tumor markers and their clinical significance in epithelial ovarian cancer

作　　者：单冬勇[1] 成树林[1] 马邺晨 彭红华[1] SHAN Dongyong;CHENG Shulin;MA Yechen;PENG Honghua(Department of Oncology,Third Xiangya Hospital,Central South University,Changsha 410013,China)

机构地区：[1]中南大学湘雅三医院肿瘤科,长沙410013

出　　处：《中南大学学报（医学版）》2023年第7期1039-1049,共11页Journal of Central South University ：Medical Science

基　　金：supported by the Natural Science Foundation of Hunan Province,China(2018JJ3791).

摘　　要：目的:肿瘤标志物已广泛应用于临床。血清CA125检测是目前临床常用的上皮卵巢癌早期筛查和早期诊断方法之一,但使用单一特异性肿瘤标志物诊断上皮性卵巢癌比较困难。本研究采用肿瘤标志物组合检测法,比较各肿瘤标志物单独检测与联合检测在上皮性卵巢癌诊断中的价值。方法:收集上皮性卵巢癌患者(n=65)和卵巢良性疾病患者(n=29)的临床资料。采用多肿瘤标志物蛋白质芯片检测癌抗原125(cancer antigen 125,CA125)、糖类抗原242(carbohydrate antigen 242,CA242)、甲胎蛋白(alpha-fetoprotein,AFP)、β-人绒毛膜促性腺激素(beta-human chorionic gonadotropin,β-HCG)、癌胚抗原(carcinoembryonic antigen,CEA)、癌抗原199(cancer antigen 199,CA1990)、神经元-特性烯醇化酶(neuron-specific enolase,NSE)、铁蛋白(Ferritin)、癌抗原153(cancer antigen 153,CA153)以及人生长激素(human growth hormone,HGH)的血清水平,比较其在卵巢良恶性肿瘤中的差异;χ2检验分析肿瘤标志物与卵巢上皮癌患者临床病理特征的相关性;Spearman秩关性分析上皮性卵巢癌CA125与其他肿瘤标志物表达水平及年龄与上述10种肿瘤标志物的相关性;采用灵敏度、特异度、阳性预测值、阴性预测值、约登指数及诊断效率分别评价各肿瘤标志物单项检测及联合检测的诊断价值。结果:上皮性卵巢癌组中的β-HCG、NSE、CA153和CA125水平均高于卵巢良性疾病组。上皮性卵巢癌患者血清中NSE的水平与患者的临床分期相关。此外,上皮性卵巢癌患者血清中CA242、β-HCG、CEA、NSE、Ferritin、CA153水平与CA125水平呈正相关(分别rs=0.497、P<0.001;rs=0.612、P<0.001;rs=0.358、P=0.003;rs=0.680、P<0.001;rs=0.322、P=0.009;rs=0.609、P<0.001),β-HCG、Ferritin、CA153水平与患者年龄呈正相关(分别rs=0.256、P=0.040;rs=0.325、P=0.008;rs=0.249、P=0.046)。在上皮性卵巢癌诊断中,CA125单独检测的灵敏度、约登指数及诊断效率均高�Objective:Tumor markers have been widely used clinically.Detection of serum CA125 is one of the commonly used clinical methods for early screening and early diagnosis of epithelial ovarian cancer,but it is difficult to diagnose epithelial ovarian cancer with a single specific tumor marker.In this study,the combinatorial tumor marker detection method was used to compare the value of each tumor marker alone and different combinations in the diagnosis of epithelial ovarian cancer.Methods:The clinical data of patients with epithelial ovarian cancer(n=65)and ovarian benign disease(n=29)were collected.Multiple tumor marker protein chip was used to detect cancer antigen 125(CA125),carbohydrate antigen 242(CA242),alpha-fetoprotein(AFP),beta-human chorionic gonadotropin(β-HCG),carcinoembryonic antigen(CEA),cancer antigen 199(CA199),neuron-specific enolase(NSE),Ferritin,cancer antigen 153(CA153),and human growth hormone(HGH)serum levels,and to compare the differences between the benign and malignant ovarian tumors.The correlation between tumor markers and clinicopathologic features for ovarian epithelial carcinoma was analyzed byχ2 test.Spearman rank analysis showed the correlation between CA125 expression level and other tumor markers in epithelial ovarian cancer and the correlation between age and the above 10 tumor markers.Sensitivity,specificity,positive predictive value,negative predictive value,Youden index,and diagnostic efficiency were used to evaluate the diagnostic value of single tumor marker and the combination of tumor markers.Results:The levels ofβ-HCG,NSE,CA153,and CA125 in the epithelial ovarian cancer group were higher than those in the ovarian benign disease group.The level of NSE in the serum of patients with epithelial ovarian cancer was related to the clinical stage of patients.In addition,the levels of CA242,β-HCG,CEA,NSE,Ferritin,CA153 in the serum of patients with epithelial ovarian cancer were positively correlated with CA125(rs=0.497,P<0.001;rs=0.612,P<0.001;rs=0.358,P=0.003;rs=0.680,P<0.001;r

关 键 词：上皮性卵巢癌 肿瘤标志物 蛋白质芯片化学发光 联合评估 诊断价值 

分 类 号：R737.31[医药卫生—肿瘤]