基于血清HE4、PLR、RLX、KPNA2构建晚期卵巢上皮性癌术后复发风险预测模型的临床研究  

Clinical study on the construction of risk prediction model for postoperative recurrence of advanced epithelial ovarian cancer based on serum HE4,PLR,RLX and KPNA2

作　　者：沈晨 王轶 郑翠[1] 杨军 SHEN Chen;WANG Yi;ZHENG Cui;YANG Jun(Department of Gynaecology and Obstetrics;Department of Oncology,Suzhou Municipal Hospital(East District),Suzhou,Jiangsu 215000,China)

机构地区：[1]苏州市立医院(东区)妇产科 [2]苏州市立医院(东区)肿瘤科,江苏苏州215000

出　　处：《国际检验医学杂志》2024年第3期295-300,共6页International Journal of Laboratory Medicine

基　　金：2022年度江苏省妇幼保健科研项目(F202207)。

摘　　要：目的探讨基于血清人附睾蛋白4(HE4)、血小板计数/淋巴细胞计数比值(PLR)、血清松弛素(RLX)、核转运蛋白α2(KPNA2)构建晚期卵巢上皮性癌术后复发风险预测模型。方法选取2016年1月至2019年1月苏州市立医院(东区)诊治的124例晚期卵巢上皮性癌患者作为研究对象,根据晚期卵巢上皮性癌患者是否复发分为复发组和无复发组。HE4水平采用电化学发光免疫分析法检测,根据血常规结果计算PLR,酶联免疫吸附试验检测RLX、KPNA2水平。晚期卵巢上皮性癌患者术后复发的影响因素采用多因素Logistic回归分析,并建立晚期卵巢上皮性癌术后复发风险预测模型。采用受试者工作特征(ROC)曲线评估晚期卵巢上皮性癌术后复发风险预测模型的预测效能,利用Hosmer-Lemeshow检验分析患者晚期卵巢上皮性癌术后复发风险预测模型的拟合度。结果复发组与无复发组在肿瘤国际妇产科联盟(FIGO)分期及血清糖类抗原125、HE4、PLR、RLX、KPNA2水平比较,差异有统计学意义(P<0.05)。肿瘤FIGO分期Ⅳ期及血清HE4、PLR、RLX、KPNA2升高是晚期卵巢上皮性癌患者术后复发的危险因素(P<0.05)。ROC曲线分析显示,晚期卵巢上皮性癌术后复发风险预测模型的曲线下面积为0.859,均明显高于HE4、PLR、RLX、KPNA2单一指标检测。通过Hosmer-Lemeshow检验分析,晚期卵巢上皮性癌术后复发风险预测模型有较好的拟合度(χ^(2)=7.869,P=0.437)。结论基于血清HE4、PLR、RLX、KPNA2及肿瘤FIGO分期构建的晚期卵巢上皮性癌术后复发风险预测模型对于评估患者晚期卵巢上皮性癌术后复发具有较高的预测价值,值得临床关注。Objective To study the construction of risk prediction model for postoperative recurrence of advanced epithelial ovarian cancer based on serum human epididymis protein 4(HE4),platelet count/lymphocyte count ratio(PLR),relaxin(RLX),karyopherinα2(KPNA2).Methods 124 patients with advanced epithelial ovarian cancer diagnosed and treated in Suzhou Municipal Hospital(East District)from January 2016 to January 2019 were selected as the study objects,patients with advanced epithelial ovarian cancer were divided into recurrence group and the non-recurrence group based on whether they had recurred or not.The level of HE4 was detected by electrochemical luminescence immunoassay,PLR was calculated according to the blood routine results,and RLX and KPNA2 levels were detected by enzyme-related immunosorbent assay.Multivariate Logistic regression analysis was used to analyze the influencing factors of postoperative recurrence in patients with advanced epithelial ovarian cancer,and establish a risk prediction model for postoperative recurrence of advanced epithelial ovarian cancer.Receiver operating characteristic(ROC)curve was used to evaluate the predictive efficacy of the model for postoperative recurrence of advanced epithelial ovarian cancer,and Hosmer-Lemeshow test was used to analyze the fitting of recurrence risk prediction model for patients with advanced epithelial ovarian cancer.Results There was a statistically significant difference in International Federation of Gynecology and Obstetrics(FIGO)staging and serum levels of carbohydrate antigen 125,HE4,PLR,RLX and KPNA2 between the recurrence group and the non-recurrence group(P<0.05).FIGO stagingⅣof cancer and elevated serum HE4,PLR,RLX and KPNA2 were risk factors for postoperative recurrence in patients with advanced epithelial ovarian cancer(P<0.05).ROC curve analysis showed that,the area under the curve of the recurrence risk prediction model for postoperative recurrence risk of advanced epithelial ovarian cancer was 0.859,which was significantly higher than tha

关 键 词：晚期卵巢上皮性癌 人附睾蛋白4 血小板计数/淋巴细胞计数比值 松弛素 核转运蛋白α2 

分 类 号：R737.31[医药卫生—肿瘤]