摘要
【目的】探讨术前血清炎症标志物在子宫内膜癌中的预测价值。【方法】回顾性分析中山大学附属第三医院2020年1月至2023年12月经病理确诊的子宫内膜非典型增生及子宫内膜癌患者的实验室及临床病理资料,分析两组患者基本信息间的差异,通过Mann-Whitney U检验对比术前血清炎症标志物及肿瘤标志物在两组患者间的差异,有差异的指标使用ROC曲线来分析其特异度、敏感度及最佳截断值。共408名患者纳入研究,其中子宫内膜非典型增生组82名患者,子宫内膜癌组326名患者。【结果】患者术前血清白细胞计数(P=0.039)、单核细胞计数(P=0.046)、血小板计数(P=0.0317)、血小板/淋巴细胞比值(PLR)(P=0.017)、CA-125(P<0.0001)、HE4(P<0.0001)在子宫内膜非典型增生和子宫内膜癌间有统计学差异,为这些存在差异的指标绘制ROC曲线,结果显示白细胞(P=0.041)、血小板(P=0.045)、PLR(P=0.007)、CA-125(P<0.0001)、HE4(P<0.0001)在子宫内膜癌的识别中,其预测价值具有统计学意义。对比单个指标,联合指标CA-125+HE4+PLR+白细胞+单核细胞具有最大AUC[0.76(0.70~0.81)],其预测价值更高。【结论】CA-125+HE4+PLR+白细胞+单核细胞联合筛查可帮助识别子宫内膜癌,为子宫内膜非典型增生及早期内膜癌保守治疗的患者提供有效的信息。
【Objective】To explore the predictive value of preoperative serum inflammatory indicators in endometrial cancer.【Methods】The laboratory and clinical pathological data of patients with endometrial atypical hyperplasia and endometrial cancer diagnosed by pathology from January 2020 to December 2023 in the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed.The differences in basic information between the two groups of patients were analyzed.The Mann-Whitney U test was used to compare the differences in preoperative serum inflammatory indicators and tumor markers between the two groups of patients.The ROC curve was used to analyze the specificity,sensitivity and optimal cutoff value of the different indicators.A total of 408 patients were included in the study,including 82 patients in the endometrial atypical hyperplasia group and 326 patients in the endometrial cancer group.【Results】There were statistical differences in preoperative serum leukocyte count(P=0.039),monocyte count(P=0.046),platelet count(P=0.0317),platelet/lymphocyte ratio(PLR)(P=0.017),CA-125(P<0.0001),and HE4(P<0.0001)between endometrial atypical hyperplasia and endometrial carcinoma.ROC curves were drawn for these different indicators,and the results showed that leukocyte(P=0.041),platelet(P=0.045),PLR(P=0.007),CA-125(P<0.0001),and HE 4(P<0.0001)had statistically significant predictive values in endometrial carcinoma.Compared with single indicators,the combined indicator CA-125+HE 4+PLR+leukocytes+monocytes had the largest AUC[0.76(0.70-0.81)],and its predictive value is higher.【Conclusion】CA-125+HE 4+PLR+leukocytes+monocytes combined screening can help to identify endometrial cancer,and provide effective information for patients with endometrial atypical hyperplasia and early endometrial cancer who are conservatively treated.
作者
王英祥
古健
王佳
WANG Yingxiang;GU Jian;WANG Jia(Department of Gynecology,The Third Affiliated Hospital,Sun Yat-sen University,Guangzhou 510630,China)
出处
《中山大学学报（医学科学版）》
CAS
CSCD
北大核心
2024年第6期923-929,共7页
Journal of Sun Yat-Sen University:Medical Sciences
关键词
子宫内膜不典型增生
子宫内膜癌
血清炎症标记物
肿瘤标记物
受试者工作特征曲线
endometrial atypical hyperplasia
endometrial cancer
serum inflammatory markers
tumor markers
receiver operating characteristic curve
