血清HSP70、PKD1、YKL-40对绝经后早期子宫内膜癌淋巴结转移的预测效能  

The predictive efficacy of serum HSP70,PKD1 and YKL-40 for lymph node metastasis in postmenopausal early endometrial cancer

作　　者：丁祺 杨红玉 孙亚楠 刘丽爽 DING Qi;YANG Hongyu;SUN Yanan;LIU Lishuang(Department of Obstetrics and Gynecology,No.980 Hospital of PLA Joint Logistic Support Force,Shijiazhuang 050000,China)

机构地区：[1]中国人民解放军联勤保障部队第九八〇医院妇产科,石家庄050000

出　　处：《广西医科大学学报》2024年第1期92-97,共6页Journal of Guangxi Medical University

基　　金：2019年度河北省医学科学研究课题计划项目(No.20191218)。

摘　　要：目的:探讨血清热休克蛋白70(HSP70)、蛋白激酶D1(PKD1)、甲壳质酶蛋白40(YKL-40)与绝经后早期子宫内膜癌淋巴结转移的关系及预测效能。方法:选取2021年3月至2023年3月中国人民解放军联勤保障部队第九八〇医院收治的126例绝经后早期子宫内膜癌患者(研究组),根据术后病理诊断结果分为淋巴结转移组(n=22)和非淋巴结转移组(n=104)。另选取114例健康体检者作为对照组。比较各组血清HSP70、PKD1和YKL-40水平。采用多因素logistic回归分析方法分析影响患者发生淋巴结转移的因素,受试者工作特征(ROC)曲线分析血清HSP70、PKD1和YKL-40水平对患者淋巴结转移的预测价值。结果:研究组血清HSP70、PKD1和YKL-40水平均高于对照组(P<0.05)。淋巴结转移组患者低分化、子宫肌层浸润≥50%及血清CA125、HE4、HSP70、PKD1和YKL-40水平高于非淋巴结转移组(P<0.05)。多因素logistic回归分析显示,血清HE4、HSP70、PKD1和YKL-40水平及子宫肌层浸润≥50%均为绝经后早期子宫内膜癌患者发生淋巴结转移的独立危险因素(均P<0.05)。血清HSP70、PKD1和YKL-40水平预测绝经后早期子宫内膜癌患者发生淋巴结转移的最佳截断点分别为90.82μg/L、132.23μg/L、75.32μg/L,三者联合预测的灵敏度、特异度和ROC曲线下面积(AUC)分别为81.82%、96.15%、0.940。结论:早期子宫内膜癌患者血清HSP70、PKD1、YKL-40水平可作为预测淋巴结转移的敏感指标,且三者联合预测的预测效能更高。Objective:To explore the relationship and predictive efficacy of serum heat shock protein 70(HSP70),protein kinase D1(PKD1),chitinase protein 40(YKL-40)with lymph node metastasis in postmenopausal early endometrial cancer.Methods:A total of 126 patients with postmenopausal early endometrial cancer admitted to No.980 Hospital of PLA Joint Logistics Support Force from March 2021 to March 2023 were selected as the study group and divided into lymph node metastasis group(n=22)and non-lymph node metastasis group(n=104)according to the postoperative pathological diagnosis.Another 114 healthy individuals were selected as the control group.The serum levels of HSP70,PKD1 and YKL-40 in each group were compared.Multivariate logistic regression analysis was used to analyze the factors affecting lymph node metastasis of patients.The receiver operating characteristic(ROC)curve was used to analyze the predictive value of serum HSP70,PKD1 and YKL-40 levels for lymph node metastasis of patients.Results:The serum levels of HSP70,PKD1 and YKL-40 in the study group were higher than those in the control group(P<0.05).The proportion of low differentiation,uterine myometrial infiltration≥50%,and serum levels of CA125,HE4,HSP70,PKD1,and YKL-40 in patients with lymph node metastasis were higher than those in patients without lymph node metastasis(P<0.05).Multivariate logistic regression analysis showed that serum HE4,HSP70,PKD1 and YKL-40 levels and uterine myometrial infiltration≥50%were all independent risk factors for lymph node metastasis in patients with postmenopausal early endometrial cancer(all P<0.05).The optimal cutoff points for serum HSP70,PKD1,and YKL-40 levels predicting lymph node metastasis in postmenopausal early endometrial cancer patients were 90.82μg/L,132.23μg/L,and 75.32μg/L,respectively.The sensitivity,specificity,and area under the ROC curve(AUC)of the combined prediction of the three factors were 81.82%,96.15%,and 0.940,respectively.Conclusion:The serum levels of HSP70,PKD1 and YKL-40 in patients with earl

关 键 词：子宫内膜癌 淋巴结转移 绝经 热休克蛋白70 蛋白激酶D1 甲壳质酶蛋白40 

分 类 号：R445.1[医药卫生—影像医学与核医学]