经阴道超声联合血清ZEB1、LAG-3在子宫内膜癌早期诊断中的临床价值  

Clinical value of transvaginal ultrasound combined with serum ZEB1 and LAG-3 in the early diagnosis of endometrial cancer

作　　者：高成英[1] 周文蓉[1] 窦增娟 GAO Chengying;ZHOU Wenrong;DOU Zengjuan(Department of Ultrasound,Qinghai Red Cross Hospital,Xining,Qinghai 810000,China;Department of Gynecology,Qinghai Red Cross Hospital,Xining,Qinghai 810000,China)

机构地区：[1]青海红十字医院超声科,青海西宁810000 [2]青海红十字医院妇科,青海西宁810000

出　　处：《国际检验医学杂志》2025年第9期1066-1070,共5页International Journal of Laboratory Medicine

基　　金：中国人类遗传资源采集审批申请书(2021SQCJ7714)。

摘　　要：目的研究经阴道超声联合血清E盒结合锌指蛋白1(ZEB1)、淋巴细胞活化基因-3(LAG-3)在子宫内膜癌早期诊断中的临床价值。方法选取2021年7月至2023年8月在该院就诊的子宫内膜癌疑似患者97例,经子宫内膜活体病理学检查,分为恶性组(46例)、良性组(51例)。收集患者的临床病理特征,对患者进行阴道超声检查以及血清ZEB1 mRNA、LAG-3水平检测。Kappa检验分析经阴道超声、ZEB1 mRNA、LAG-3及三者联合诊断与活检诊断的一致性;受试者工作特征(ROC)曲线比较经阴道超声、ZEB1 mRNA、LAG-3及三者联合对子宫内膜癌早期诊断的价值。结果恶性组ZEB1 mRNA、LAG-3水平高于良性组(P<0.05)。国际妇产科联盟(FIGO)分期>Ⅱ级、肌层深层浸润、远处转移、低分化患者的ZEB1 mRNA、LAG-3水平均高于FIGO分期≤Ⅱ级、肌层浅层浸润、未远处转移、中高分化患者(P<0.05)。联合经阴道超声、ZEB1 mRNA、LAG-3诊断与活检诊断的一致性(Kappa=0.751)高于单独诊断(Kappa=0.647、0.605、0.666)。联合经阴道超声、ZEB1 mRNA、LAG-3诊断早期子宫内膜癌的曲线下面积(AUC)最高为0.925,灵敏度为84.78%、特异度为90.20%、准确度为87.63%、约登指数为0.750。结论早期子宫内膜癌患者血清ZEB1、LAG-3水平较高,血清ZEB1、LAG-3水平与患者临床特征有关,联合经阴道超声、ZEB1及LAG-3在子宫内膜癌早期诊断中具有较高的临床价值。Objective To investigate the clinical value of transvaginal ultrasound combined with serum zinc finger E-box-binding homeobox 1(ZEB1)and lymphocyte activation gene 3(LAG-3)in the early diagnosis of endometrial cancer.Methods From July 2021 to August 2023,totally 97 suspected patients with endometrial cancer who visited the hospital were collected in the study.After endometrial biopsy,they were separated into malignant group(46 cases)and benign group(51 cases).The clinical and pathological characteristics of the patients were collected,vaginal ultrasound examination was performed on the patients,and serum ZEB1 mRNA and LAG-3 levels were detected.Kappa test was applied to analyze the consistency between transvaginal ultrasound,ZEB1 mRNA,LAG-3,and their combined diagnosis and biopsy diagnosis.Receiver operating characteristic(ROC)curve was applied to compare the value of transvaginal ultrasound,ZEB1 mRNA,LAG-3 and their combination in the early diagnosis of endometrial cancer.Results The levels of ZEB1mRNA and LAG-3 in the malignant group were higher than those in the benign group(P<0.05).Patients with International Federation of Gynecology and Obstetrics(FIGO)staging>gradeⅡ,deep muscle infiltration,distant metastasis,low-grade had higher ZEB1mRNA and LAG-3 levels than patients with FIGO staging≤gradeⅡ,superficial muscle infiltration,no distant metastasis and medium to high differentiation(P<0.05).The consistency combined between transvaginal ultrasound,ZEB1mRNA,LAG-3 diagnosis and biopsy diagnosis(Kappa=0.751)was higher than that of the three individual diagnoses(Kappa=0.647,0.605,0.666).The area under the curve(AUC)of combined transvaginal ultrasound,ZEB1mRNA,and LAG-3 in the diagnosis of early endometrial cancer was the largest,which was 0.925,with sensitivity of 84.78%,specificity of 90.20%,accuracy of 87.63%,and Youden index of 0.750.Conclusion The expression of serum ZEB1 and LAG-3 is relatively high in patients with early endometrial cancer.The levels of serum ZEB1 and LAG-3 are related to the clinical

关 键 词：子宫内膜癌 诊断 经阴道超声 E盒结合锌指蛋白1 淋巴细胞活化基因-3 

分 类 号：R737.33[医药卫生—肿瘤]