摘要
目的探讨血清DKK-4、nidogen-2与人附睾蛋白4 (human epididymis protein 4,HE 4)在卵巢浆液性肿瘤患者中的表达及其早期检测对卵巢浆液性肿瘤的预测价值。方法选择秦皇岛市妇幼保健院2010年11月至2017年11月收治的310例病理确诊卵巢浆液性肿瘤患者为研究对象,良性浆液性囊腺瘤204例,交界性浆液囊腺瘤42例,卵巢浆液性囊腺癌64例。采用ELISA法测定患者血清DKK-4、nidogen-2与HE 4的表达,分析其与临床病理分期的关系,同时与病理诊断结果比较分析血清DKK-4、nidogen-2与HE 4单独应用及联合诊断卵巢浆液性囊腺癌的诊断效能。结果卵巢浆液性囊腺癌组血清DKK-4、nidogen-2与HE 4水平显著高于交界性浆液囊腺瘤组和良性浆液性囊腺瘤组(P <0. 05),交界性浆液囊腺瘤组和良性浆液性囊腺瘤组上述指标比较差异无统计学意义(P> 0. 05);Ⅲ～Ⅳ期卵巢浆液性囊腺癌患者的血清DKK-4、nidogen-2与HE 4明显高于I～II期患者(P <0. 05);血清DKK-4、nidogen-2与HE 4联合检测的敏感度(90. 6%)显著高于单项检测的敏感度(85. 9%、82. 8%、68. 8%)(P <0. 05)。联合检测在提高卵巢癌检测灵敏度的同时,还保持了较高的特异性(80. 1%)和Kappa (82. 3%);血清DKK-4、nidogen-2与HE 4联合诊断的ROC曲线下面积(0. 906)显著高于各指标单独检测(0. 801、0. 760、0. 784)(P <0. 05)。结论血清DKK-4、nidogen-2与HE 4水平检测可提高卵巢浆液性癌诊断的灵敏度,并能保持较高的特异性,对卵巢浆液性癌的早期筛查诊断具有重要价值。
Objective To explore the clinical value of DKK-4 and nidogen-2 combined with HE 4 in the diagnosis of serous ovarian cancer.Methods 310 patients diagnosed of serous ovarian neoplasm by pathology admitted from November 2010 to November2017 were selected in Maternity and Child Care Center of Qinhuangdao and divided into cystadenocarcinomas group,borderline cystadenomas group and cystadenomas group according to placental pathology.Blood was collected,serum levels of DKK-4,nidogen-2 and HE 4 were measured according to ELISA,analyze the diagnostic efficiency of DKK-4,nidogen-2 and HE 4 to diagnose the serous ovarian cancer.Results Compared with the borderline cystadenomas group and cystadenomas group,the levels of DKK-4,nidogen-2 and HE 4 in cystadenocarcinomas group were significantly higher(P<0.05).The serum levels of DKK-4,nidogen-2 and HE 4 in ovarian serous cystadenocarcinoma at III-IV stages were significantly higher than those at I-II stages(P<0.05).The sensitivity(90.6 %) of combination of DKK-4,nidogen-2 and HE 4 was significantly higher than that of individual detection(85.9 %,82.8 %,68.8 %)(P<0.05).While the detection sensitivity of ovarian serous cystadenocarcinoma was improved by combined detection,high specificity(80.1 %) and Kappa(82.3 %) were maintained.The area under the ROC curve of DKK-4 and nidogen-2 combined with HE 4(0.906) was significantly higher than that of each index alone(0.801,0.760,0.784)(P<0.05).Conclusion The combination of DKK-4,nidogen-2 and HE 4 to diagnose ovarian serous cystadenocarcinoma can improve the sensitivity and maintain a high specificity,which is of great value for the early diagnosis of ovarian serous cystadenocarcinoma.
作者
赵长燕
贺红梅
张明慧
ZHAO Chang-yan;HE Hong-mei;ZHANG Ming-hui(Department of Pathology,Maternity and Child Care Center of Qinhuangdao,Qinhuangdao Hebei 066000,P.R.China)
出处
《中国计划生育和妇产科》
2019年第2期89-92,F0003,共5页
Chinese Journal of Family Planning & Gynecotokology
基金
秦皇岛市重点研发计划科技支撑项目(项目编号:201703A137)
