子宫内膜癌患者术前血清apo AI和Apelin水平检测对预测淋巴脉管间隙浸润风险的价值研究  

Value of Preoperative Serum Apo AI and Apelin Levels in Predicting the Risk of Lymph Node Vascular Space Infiltration in Patients with Endometrial Cancer

作　　者：梁燕茹 郑瑜 李倩 LIANG Yanru;ZHENG Yu;LI Qian(Department of Obstetrics and Gynecology,Shijiazhuang Maternal and Child Health Care Hospital,Shijiazhuang 050000,China;Department of Obstetrics and Gynecology,Baoding Maternal and Child Health Care Hospital,Hebei Baoding 071000,China)

机构地区：[1]石家庄市妇幼保健院妇产科,石家庄050000 [2]保定市妇幼保健院妇产科,河北保定071000

出　　处：《现代检验医学杂志》2023年第5期53-57,85,共6页Journal of Modern Laboratory Medicine

基　　金：河北省医学科学研究课题计划项目(20200277):术前血清因子预测子宫内膜癌LVSI风险的价值研究。

摘　　要：目的分析子宫内膜癌(endometrial cancer,EC)患者术前血清载脂蛋白AI(apolipoprotein A1,apo AI)和Apelin水平检测对预测子宫内膜癌淋巴结脉管间隙浸润(lymph vascular space invasion,LVSI)风险的价值。方法选取2020年2月~2022年6月石家庄市妇幼保健院97例EC患者为研究对象,统计EC患者LVSI发生情况并比较不同结果患者的一般资料,采用Logistic回归分析EC患者LVSI风险的影响因素,采用ROC分析术前血清apo AI和Apelin水平评估EC患者LVSI风险的价值,绘制决策曲线分析术前血清apo AI和Apelin水平评估EC患者LVSI风险的净受益率,比较血清apo AI和Apelin术前不同表达水平的患者LVSI发生情况。结果97例EC患者中LVSI阴性和阳性分别为69例和28例;Logistic回归分析显示,肿瘤≥2 cm、非子宫内膜样腺癌、低分化、肌层浸润≥1/2和血清Apelin水平升高是EC患者LVSI阳性的独立危险因素,血清apo AI升高是LVSI阳性的保护因素(t/χ2=6.592,8.686,4.697,9.098,4.001,2.738均P<0.05);ROC曲线分析显示术前血清apo AI,Apelin联合检测评估EC患者LVSI风险的AUC值为0.801,高于二者单独评估的AUC值(P<0.001);决策曲线分析显示当风险阈值为0~0.55时,术前血清apo AI,Apelin联合检测的净受益率大于单独检测。结论术前血清apo AI,Apelin水平变化对评估EC患者LVSI风险具有一定预测价值。低水平apo AI与高水平Apelin表明患者LVSI风险较高。Objective To analyze the preoperative serum apolipoprotein AI(apo AI)levels in patients with endometrial cancer(EC),and the value of testing Apelin levels in predicting the risk of lymphatic vessel infiltration(LVSI)in endometrial cancer.Methods 97 cases of EC patients in the Shijiazhuang Maternal and Child Health Care Hospital from February 2020 to June 2022 were selected as the study group,and 97 cases of endometrium patients with proliferative stage were selected as the control group.Preoperative serum apo AI and Apelin levels were compared between the two groups,and the results of LVSI in EC patients were statistically analyzed and the general data of patients with different results were compared.Logistic regression was used to analyze the influencing factors of LVSI risk in EC patients,ROC was used to analyze the value of preoperative serum apo AI and Apelin levels in evaluating LVSI risk in EC patients,and a decision curve was drawn to analyze the net benefit rate of preoperative serum apo AI and Apelin levels in evaluating LVSI risk in EC patients.The occurrence of LVSI in patients with different expression levels of serum apo AI and Apelin before operation was compared.Results Among 97 EC patients,69 cases were negative and 28 cases were positive for LVSI.The pro portion number of LVSI of≥2 cm,non-endometrioid adenocarcinoma,poorly differentiated,and myoinfiltration patients with muscle infiltration≥1/2 in LVSI-positive patients was higher than that in LVSI-negative patients,the preoperative serum apo AI level was lower than that in LVSI-negative patinets,and the Apelin level was higher than that in LVSI-negative patients(t/χ^(2)=6.592,8.686,4.697,9.098,4.001,2.738,all P<0.05).ROC curve analysis showed that the AUC value of apo AI and Apelin combined preoperative serum in the assessment of LVSI risk in EC patients was 0.801,which was higher than the AUC value of APO AI and APelin alone(P<0.001).Decision curve analysis showed that when the risk threshold was 0~0.55,the net benefit rate of preoper

关 键 词：子宫内膜癌 载脂蛋白AI APELIN 淋巴脉管间隙浸润 

分 类 号：R737.33[医药卫生—肿瘤] R730.43[医药卫生—临床医学]