摘要
目的研究超敏C-反应蛋白(hs-CRP)、糖类抗原125(CA125)及人附睾蛋白4(HE4)联合检测在子宫内膜癌诊断及预后中的价值。方法选取拟进行手术治疗的良性、恶性子宫内膜病变患者120例为试验组,按照疾病程度分为子宫内膜癌和子宫内膜良性病变。另选取同期进行体检的健康女性50例为对照组。术前检测2组hsCRP、CA125及HE4,判断有效性及预后。结果与对照组比较,试验组患者血清hs-CRP、CA125、HE4水平均显著升高,且随着病情加重,hs-CRP、CA125、HE4水平提高,与对照组比较差异有统计学意义(P<0.05)。试验组hs-CRP阳性率显著高于对照组,差异有统计学意义(P<0.05)。试验组hs-CRP、CA125、HE4检测阳性率均显著高于对照组(P<0.05)。与对照组比较,试验组血清hs-CRP、CA125、HE4水平比较差异无统计学意义(P>0.05)。与对照组比较,试验组血清hs-CRP、CA125、HE4阳性率差异无统计学意义(P>0.05)。使用ROC曲线分析结果表明,hs-CRP、CA125、HE4三项联合检测曲线下面积最大,为0.835;单项检测时,HE4曲线下面积最大,为0.806,较hs-CRP、CA125均高,分别为0.683和0.670。子宫内膜癌三项联合诊断的敏感性和特异性分别为64.7%和98.1%,Youden指数为0.65,显著优于单项指标检测时的诊断能力。HE4的诊断效能优于hs-CRP、CA125,其诊断敏感性和Youden指数显著高于其他两项,差异有统计学意义(P<0.05)。结论 hs-CRP、CA125及HE4联合检测子宫内膜癌效能优于单项检测,灵敏度高,准确性好,可对患者预后提供参考,值得临床推广应用。
Objective To investigate the diagnostic and prognostic value of combination detection of high sensitivity C reactive protein （hs-CRP）,carbohydrate antigen 125 （CA125） and HE4 in endometrial carcinoma.Methods One hundred and twenty patients with benign or malignant endometrial lesions were enrolled in the study .According to the disease degree , these patients were divided into endometrial cancer group （trial group） and endometrial benign lesion group （control group）, at the same time, 50 healthy women were served as control group .The levels of hs-CRP, CA125 and HE4 were detected before operation to evaluate the effectiveness and prognosis .Results As compared with those in control group , the serum levels of hs-CRP,CA125,HE4 in trial group were obviously increased ,moreover, with the aggravation of disease degree ,the serum levels of hs-CRP,CA125,HE4 were significantly increased （ P〈0.05）.The positive rate of hs-CRP was 55.83%in trial group,which was significantly higher than that in control group （ P〈0.05）.The detection positive rates of hs-CRP, CA125,HE4 in trial group were significantly higher than those in control group （ P〈0.05）.After operation there were no significant differences in the serum levels of hs-CRP,CA125,HE4 between trial group and control group （ P〉0.05）, moreover, there were no significant differences in detection positive rates of hs-CRP,CA125,HE4 between trial group and control group （ P〉0.05）.The ROC curve analysis combined with single detection or combination detection of hs -CRP, CA125,HE4, human epididymis protein 4 showed that the area under curve detected by combination detection of hs -CRP, CA125,human epididymis protein 4 was the largest （0.835）,however, in single detection of HE4,the area under curve was the largest （0.806）,which was greater than that of hs-CRP （0,683） and that of CA125 （0.670）.The sensitivity and specificity of combined detection of three indexes in diagnosis of endometrial cancer were 64.7% and 98.1%,respectively, with Youden index being 0.65,which were superior to those of single detection .The diagnostic efficacy of single detection of human epididymis protein 4 was superior to that of hs-CRP and CA125,moreover, its diagnostic sensitivity and specificity as well as Youden index were significantly higher than those of hs-CRP and CA125 （ P〈0.05）.Conclusion The combination detection of hs-CRP,CA125,HE4 in diagnosis of endometrial carcinoma is superior to single detection ,with high sensitivity and good accuracy ,thus ,which is worth using widely in clinical practice .
出处
《河北医药》
CAS
2017年第1期21-23,27,共4页
Hebei Medical Journal
