摘要
目的探讨糖类抗原125(carbohydrate antigen 125,CA125)和血清人附睾蛋白4(human epididy⁃mal secretion protein 4,HE4)对评估子宫内膜癌患者淋巴结转移的临床应用价值。方法回顾性收集2015年10月至2019年7月就诊于陕西省人民医院妇科的154例子宫内膜癌患者,收集其临床资料,包括年龄、绝经状态,分期、分化、子宫肌层浸润深度、淋巴结转移、CA125及HE4水平。分析HE4及CA125与不同子宫内膜癌患者临床病理资料之间的关系,运用ROC(receiver operating characteristic)曲线检测HE4及CA125水平诊断子宫内膜癌患者淋巴结转移的最佳临界值,运用单因素及多因素分析子宫内膜癌淋巴结转移的相关因素。结果血清CA125水平与子宫内膜癌患者的分期、子宫肌层浸润深度、淋巴结转移情况密切相关(P<0.05);HE4水平与其分期、分化、浸润深度、淋巴结转移、绝经状态密切相关(P<0.05);HE4诊断淋巴结转移的ROC曲线下面积为0.892,最佳临界值为143.45 pmol/L,敏感度为88.9%,特异度为87.5%;CA125诊断淋巴结转移的ROC曲线下面积为0.792,最佳临界值为34.975 U/mL,敏感度为72.2%,特异度为81.6%;单因素分析显示淋巴结转移与分期、分化、浸润深度、CA125、HE4密切相关(P<0.05);多因素分析显示分期、子宫肌层间质浸润深度、HE4是子宫内膜癌患者淋巴结转移的独立预测因素。结论HE4及CA125可用于评估子宫内膜癌患者淋巴结转移,且HE4诊断价值更高,为临床制定治疗方案提供参考依据。
Objective This article aimed to evaluate the clinical value of human epididymal secretory protein 4(HE4)and carbohydrate antigen 125(CA125)in the diagnosis of lymph node metastasis of endometrial cancer.Method We retrospectively included 154 endometrial cancer patients hospitalized in the Shanxi Provin⁃cial People′s hospital from October 2015 to July 2019.Clinical data was collected,including age,menopausal status,stage,differentiation,infiltration depth of myometrium,lymph node metastasis,CA125 value and HE4 value.The relationship between HE4/CA125 and different clinicopathologies was analyzed.The receiver operating characteristic(ROC)curve was used to detect the optimal critical value of HE4 and CA125 in diagnosing lymph node metastasis in patients with endometrial cancer.The correlation factors of lymph node metastasis were analyzed by univariate analysis and multivariate analysis.Results Serum CA125 was closely related to the stage of endome⁃trial cancer,infiltration depth of myometrium and lymph node metastasis(P<0.05).HE4 was closely related to stage,differentiation,infiltration depth of myometrium,lymph node metastasis and menopausal status(P<0.05).The area under the ROC curve of HE4 in diagnosing lymph node metastasis was 0.892,the best critical value was 143.45 pmol/L,the sensitivity was 88.9%,and the specificity was 87.5%.The area under ROC curve of CA125 in diagnosing lymph node metastasis was 0.792,the best critical value was 34.975 U/mL,the sensitivity was 72.2%,and the specificity was 81.6%.Univariate analysis showed that lymph node metastasis was closely related to stage,differentiation,infiltration depth of myometrium,CA125 and HE4(P<0.05).Multivariate analysis showed that stage,myometrium infiltration,and HE4 were independent predictors of lymph node metastasis in patients with endometrial cancer.Conclusion HE4 and CA125 can be used to evaluate lymph node metastasis in patients with endometrial cancer,and the diagnostic value of HE4 is higher,which provides a reference for clinical treatment planning.
作者
张瑜
张静
王乐
王飞
ZHANG Yu;ZHANG Jing;WANG Le;WANG Fei(Department of Gynaecology,Shaanxi Provincial People′s hospital,Xi′an 710068,China)
出处
《实用医学杂志》
CAS
北大核心
2020年第10期1340-1343,1348,共5页
The Journal of Practical Medicine
基金
陕西省2018年重点研计划—社会发展领域项目(编号:2018SF-253)。
