血清NLR、Apelin、HE4表达与子宫内膜癌临床特征的关系及其诊断价值分析  

The reationship between the expression of serum NLR,Apelin and HE4 in endometrial carcinoma and clinical features and its diagnostic value analysis

作　　者：郭雁 王朝霞[2] Guwo Yan;Wang Zhaoxia(Department of Gynecology,Shanxi Fenyang Hospital,Fenyang Shanxi 032200;Department of Gynecology,First Hospital of Shanxi Medical University,Taiyuan Shanxi 030001,P.R.China)

机构地区：[1]山西省汾阳医院妇科,山西汾阳032200 [2]山西医科大学第一医院妇科,山西太原030001

出　　处：《中国计划生育和妇产科》2024年第4期41-46,F0003,共7页Chinese Journal of Family Planning & Gynecotokology

基　　金：山西省基础研究自然科学研究面上项目(项目编号:20210302123244);山西省卫健委“四个一批”重点攻关专项资助项目(项目编号:2021XM36)。

摘　　要：目的探究血清中性粒细胞与淋巴细胞比值(neutrophil-lymphocyte ratio,NLR)、Apelin、人附睾蛋白4(human epididymis protein 4,HE4)在子宫内膜癌中的表达及影响因素。方法选取2021年3月至2023年3月山西省汾阳医院收治的120例疑似子宫内膜病变患者临床资料开展回顾性研究,经病理检查确诊为良性病变组96例,子宫内膜癌组24例,比较两组的NLR、Apelin、HE4水平差异,分析子宫内膜癌影响因素,并分析NLR、Apelin、HE4与子宫内膜癌临床病理特征的关系;通过ROC曲线分析NLR、Apelin、HE4与联合数据诊断子宫内膜癌的价值。结果子宫内膜癌组NLR、Apelin、HE4高于良性病变组(P<0.05)。二元Logistic回归分析显示,合并糖尿病、子宫内膜异常回声、绝经时长、子宫内膜厚度、NLR、Apelin、HE4均是发生子宫内膜癌的危险因素(P<0.05)。NLR、Apelin、HE4均与年龄、合并高血脂症、合并高血压、绝经状态、脉管间隙受累无关(P>0.05),但与合并糖尿病、组织学分类、宫颈受累、浸润深度相关(P<0.05)。ROC曲线分析显示,NLR、Apelin、HE4诊断子宫内膜癌的AUC分别为0.785、0.765、0.786;诊断灵敏度、特异度:NLR为54.2%、100.0%;Apelin为50.0%、95.8%;HE4为50.0%、100.0%,联合数据诊断子宫内膜癌的AUC为0.832,敏感度为74.2%、特异性为95.8%。结论NLR、Apelin、HE4在子宫内膜癌血清中高表达,且与其临床特征相关密切,可用于诊断子宫内膜癌,且联合诊断准确性更好;而合并糖尿病、子宫内膜异常回声、绝经时长、子宫内膜厚度、NLR、Apelin、HE4均是子宫内膜癌发生的危险因素。Objective To investigate the expression of neutrophil-lymphocyte ratio(NLR),Apelin and human epididymis protein 4(HE4)in endometrial carcinoma and its influencing factors.Methods The clinical data of 120 patients with suspected endometrial lesions admitted to the Shanxi Fenyang Hospital from March 2021 to March 2023 were selected for retrospective study;96 patients were diagnosed as benign lesions by pathological examination were inciuded in the benign lesion group and 24 patients of endometrial cancer were included in the endometrial cancer group.The differences of NLR,Apelin,HE4 levels between two groups,the infiuencing factors of endometrial cancer were analyzed,and analyzed the relationship between NLR,Apelin,HE4 and clinical pathological features of endometrial cancer;the value of NLR,Apelin,HE4 and combined data in diagnosis of ebdometrial cancer was analyzed by ROC curve.Results NLR,Apelin,and HE4 were higher in endometrial cancer group than in benign lesions group(P<0.05).Binary Logistic regression analysis showed that combined diabetes mellitus,abnormal endometrial echo,menopause length,endometrial thickness,NLR,Apelin,and HE4 were all risk factors for endometrial cancer development(P<0.05).NLR,Apelin,and HE4 were not associated with age,hyperlipidemia,hypertension,menopausal status,and vascular space involvement(P>0.05),but all were associated with diabetes,histological classification,cervical involvement,and depth of invasion(P<0.05).ROC curve analysis showed that AUC for NLR,Apelin and HE4 were 0.785,0.765 and 0.786,respectively;diagnostic sensitivity and specificity:NLR were 54.2%and 100.0%;Apelin were 50.0%and 95.8%;HE4 were 50.0%and 100.0%.The AUC of combined data in the diagnosis of endometrial cancer was 0.832,the sensitivity was 74.2%and specificity was 95.8%.Conclusion NLR,Apelin and HE4 are highly expressed in the serum of endometrial cancer,and are closely related to the clinical features of endometrial cancer,so they can be used to diagnose endometrial cancer,and the combined diagnosis is mo

关 键 词：子宫内膜癌 中性粒细胞与淋巴细胞比值 APELIN 人附睾蛋白4 表达 影响因素 

分 类 号：R711.74[医药卫生—妇产科学]