血清SCC-Ag、CEA、CYFRA21-1及HE4联合检测在宫颈癌诊断中的意义
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摘要
目的分析血清鳞状细胞癌抗原(SCC-Ag)、癌胚抗原(CEA)、细胞角蛋白19片段(CYFRA21-1)和人附睾上皮分泌蛋白4(HE4)联合检测在宫颈癌诊断中的临床价值。方法选取2015年12月至2017年12月在我院确诊的宫颈癌患者78例为宫颈癌组,宫颈良性疾病患者80例为良性疾病组。同时选取同期在我院接受体检的80例健康女性作为对照组,采用电化学发光法和酶联免疫吸附法检测3组研究对象血清SCC-Ag、CEA、CYFRA21-1及HE4水平。分析4种检测指标单独及联合检测在宫颈癌诊断中的意义。结果宫颈癌组患者血清SCC-Ag、CEA、CYFRA21-1及HE4水平显著高于良性疾病组与对照组,差异具有统计学意义(P <0. 05)。宫颈癌组单项指标检测的阳性率均显著高于良性疾病组与对照组;且宫颈癌组4项指标联合检测阳性率均显著高于单项指标检测结果 ,差异具有统计学意义(P <0.05)。SCC-Ag、CEA、CYFRA21-1及HE4联合诊断宫颈癌的灵敏度和准确度为88. 46%、87. 82%,显著高于单项指标检测结果 (P<0.05)。结论血清SCC-Ag、CEA、CYFRA21-1及HE4联合检测可有效提高宫颈癌诊断的灵敏度和准确度,具有较高的临床参考价值。
Objective To analyze the clinical values of serum squamous cell carcinoma antigen(SCC-Ag),carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1) and human epididymal epithelial secretory protein 4(HE4) in the diagnosis of cervical cancer. Methods 78 patients with cervical cancer diagnosed in our hospital from December,2015 to December,2017 were selected as the cervical cancer group,while 80 patients with benign cervical diseases were selected as the benign disease group. At the same time,80 healthy women who underwent physical examinations in our hospital were selected as the control group. The levels of serum SCC-Ag, CEA, CYFRA21-1 and HE4 in the three groups were detected by electrochemiluminescence and enzyme-linked immunosorbent assay. The significances of the four detection indicators alone or in combination in the diagnosis of cervical cancer were then analyzed. Results The levels of serum SCC-Ag,CEA,CYFRA21-1 and HE4 in the cervical cancer group were significantly higher than those in the benign disease group and the control group(P < 0. 05). The positive rate of single index detection in the cervical cancer group was significantly higher than that in the benign disease group and the control group, and the positive rate of combined detection of four indicators was significantly higher than that of single marker index in the cervical cancer group(P < 0. 05). The sensitivity and accuracy of SCC-Ag,CEA,CYFRA21-1 and HE4 in combination in the diagnosis of cervical cancer were 88.46% and 87. 82%,respectively,which were significantly higher than those of single marker index(P <0. 05). Conclusion The combined detection of serum SCC-Ag, CEA, CYFRA21-1 and HE4 can effectively improve the sensitivity and accuracy of cervical cancer diagnosis,which has a high clinical reference value.
Objective To analyze the clinical values of serum squamous cell carcinoma antigen(SCC-Ag),carcinoembryonic antigen(CEA),cytokeratin 19 fragment(CYFRA21-1) and human epididymal epithelial secretory protein 4(HE4) in the diagnosis of cervical cancer. Methods 78 patients with cervical cancer diagnosed in our hospital from December,2015 to December,2017 were selected as the cervical cancer group,while 80 patients with benign cervical diseases were selected as the benign disease group. At the same time,80 healthy women who underwent physical examinations in our hospital were selected as the control group. The levels of serum SCC-Ag, CEA, CYFRA21-1 and HE4 in the three groups were detected by electrochemiluminescence and enzyme-linked immunosorbent assay. The significances of the four detection indicators alone or in combination in the diagnosis of cervical cancer were then analyzed. Results The levels of serum SCC-Ag,CEA,CYFRA21-1 and HE4 in the cervical cancer group were significantly higher than those in the benign disease group and the control group(P < 0. 05). The positive rate of single index detection in the cervical cancer group was significantly higher than that in the benign disease group and the control group, and the positive rate of combined detection of four indicators was significantly higher than that of single marker index in the cervical cancer group(P < 0. 05). The sensitivity and accuracy of SCC-Ag,CEA,CYFRA21-1 and HE4 in combination in the diagnosis of cervical cancer were 88.46% and 87. 82%,respectively,which were significantly higher than those of single marker index(P <0. 05). Conclusion The combined detection of serum SCC-Ag, CEA, CYFRA21-1 and HE4 can effectively improve the sensitivity and accuracy of cervical cancer diagnosis,which has a high clinical reference value.
引文
[1] SMALL W,BACON M A,BAJAJ A,et al. Cervical cancer:A global health crisis[J]. Cancer,2017,123(13):2404-2412.
[2]乔友林,赵宇倩.宫颈癌的流行病学现状和预防[J].中华妇幼临床医学杂志(电子版),2015,11(2):1-6.
[3]董伟妍,王爱芹,王江莉.三阶梯技术在宫颈癌患者筛查中的应用研究[J].中国性科学,2016,25(11):45-47.
[4]常迎香,陈红青,南凤艳.宫颈癌的生物标志物分析及其临床应用前景[J].现代预防医学,2015,42(11):2107-2109.
[5] DASARIS, WUDAYAGIRI R, VALLURU L. Cervical cancer:Biomarkers for diagnosis and treatment[J]. Clin Chim Acta,2015,445:7-11.
[6]单玮,张涛,张铁军,等.我国女性人乳头瘤病毒(HPV)感染的流行病学现状[J].中华疾病控制杂志,2017,21(1):89-93.
[7] UNGER E R, BARR E. Human papillomavirus and cervical cancer[J].Emerg Infect Dis,2004,10(11):2031-2032.
[8]王颖.宫颈癌发病相关因素的研究分析[J].实用预防医学,2014,21(3):345-347.
[9] SALVATICI M,ACHILARRE M T,SANDRI M T,et al. Squamous cell carcinoma antigen(SCC-Ag)during follow-up of cervical cancer patients:Role in the early diagnosis of recurrence[J].Gynecol Oncol,2016,142(1):115-119.
[10]黄宇璐,雷嘉,范余娟.血清鳞状细胞癌抗原联合铁蛋白、癌胚抗原检测在宫颈癌临床应用的研究进展[J].医学综述,2016,22(24):4891-4894.
[11] KOTARO S,SEUI M,TAKESHI Y,et al. Utility of serum squamous cell carcinoma antigen levels at the time of recurrent cervical cancer diagnosis in determining the optimal treatment choice[J].J Gynecol Oncol,2013,24(4):321-329.
[12] JINJU o,JOO L H,SUNG LT,et al. Clinical value of routine serum squamous cell carcinoma antigen in follow-up of patients with locally advanced cervical cancer treated with radiation or chemoradiation[J]. Obstet Gynecol Sci,2016,59(4):269-278.
[13] GRUNNET M, SORENSEN J B. Carcinoembryonic antigen(CEA)as tumor marker in lung cancer[J]. Lung Cancer,2012,76(2):138-143.
[14]曾强震.肿瘤标志物CA125和CEA在妇科肿瘤诊治中的临床价值分析[J].中国实用医药,2016,11(4):99-100.
[15]李宝华,吴晓光,冯军,等.结直肠癌血清肿瘤标志CEA与CA724检测的临床意义[J].中国普通外科杂志,2015,24(7):1053-1056.
[16] SONE K,OGURI T,ITO K,et al. Predictive role of CYFRA21-1and CEA for subsequent docetaxel in non-small cell lung cancer patients[J]. Anticancer Res,2017,37(9):5125-5131.
[17] PIAO X,KONG T W, CHANG S J, et al. Pretreatment serum CYFRA 21-1 level correlates significantly with survival of cervical cancer patients:A multivariate analysis of 506 cases[J]. Gynecol Oncol,2015,138(1):89-93.
[18]邓冰彬,严檬洁,陈瑶.宫颈癌患者血清人附睾蛋白4水平的表达及临床意义[J].中国肿瘤临床与康复,2018,25(03):273-277.
[19] SIMMONS A R,BAGGERLY K,BAST B R Jr. The emerging role of HE4 in the evaluation of epithelial ovarian and endometrial carcinomas[J]. Oncology(Williston Park), 2013,27(6):548-556.
[2]乔友林,赵宇倩.宫颈癌的流行病学现状和预防[J].中华妇幼临床医学杂志(电子版),2015,11(2):1-6.
[3]董伟妍,王爱芹,王江莉.三阶梯技术在宫颈癌患者筛查中的应用研究[J].中国性科学,2016,25(11):45-47.
[4]常迎香,陈红青,南凤艳.宫颈癌的生物标志物分析及其临床应用前景[J].现代预防医学,2015,42(11):2107-2109.
[5] DASARIS, WUDAYAGIRI R, VALLURU L. Cervical cancer:Biomarkers for diagnosis and treatment[J]. Clin Chim Acta,2015,445:7-11.
[6]单玮,张涛,张铁军,等.我国女性人乳头瘤病毒(HPV)感染的流行病学现状[J].中华疾病控制杂志,2017,21(1):89-93.
[7] UNGER E R, BARR E. Human papillomavirus and cervical cancer[J].Emerg Infect Dis,2004,10(11):2031-2032.
[8]王颖.宫颈癌发病相关因素的研究分析[J].实用预防医学,2014,21(3):345-347.
[9] SALVATICI M,ACHILARRE M T,SANDRI M T,et al. Squamous cell carcinoma antigen(SCC-Ag)during follow-up of cervical cancer patients:Role in the early diagnosis of recurrence[J].Gynecol Oncol,2016,142(1):115-119.
[10]黄宇璐,雷嘉,范余娟.血清鳞状细胞癌抗原联合铁蛋白、癌胚抗原检测在宫颈癌临床应用的研究进展[J].医学综述,2016,22(24):4891-4894.
[11] KOTARO S,SEUI M,TAKESHI Y,et al. Utility of serum squamous cell carcinoma antigen levels at the time of recurrent cervical cancer diagnosis in determining the optimal treatment choice[J].J Gynecol Oncol,2013,24(4):321-329.
[12] JINJU o,JOO L H,SUNG LT,et al. Clinical value of routine serum squamous cell carcinoma antigen in follow-up of patients with locally advanced cervical cancer treated with radiation or chemoradiation[J]. Obstet Gynecol Sci,2016,59(4):269-278.
[13] GRUNNET M, SORENSEN J B. Carcinoembryonic antigen(CEA)as tumor marker in lung cancer[J]. Lung Cancer,2012,76(2):138-143.
[14]曾强震.肿瘤标志物CA125和CEA在妇科肿瘤诊治中的临床价值分析[J].中国实用医药,2016,11(4):99-100.
[15]李宝华,吴晓光,冯军,等.结直肠癌血清肿瘤标志CEA与CA724检测的临床意义[J].中国普通外科杂志,2015,24(7):1053-1056.
[16] SONE K,OGURI T,ITO K,et al. Predictive role of CYFRA21-1and CEA for subsequent docetaxel in non-small cell lung cancer patients[J]. Anticancer Res,2017,37(9):5125-5131.
[17] PIAO X,KONG T W, CHANG S J, et al. Pretreatment serum CYFRA 21-1 level correlates significantly with survival of cervical cancer patients:A multivariate analysis of 506 cases[J]. Gynecol Oncol,2015,138(1):89-93.
[18]邓冰彬,严檬洁,陈瑶.宫颈癌患者血清人附睾蛋白4水平的表达及临床意义[J].中国肿瘤临床与康复,2018,25(03):273-277.
[19] SIMMONS A R,BAGGERLY K,BAST B R Jr. The emerging role of HE4 in the evaluation of epithelial ovarian and endometrial carcinomas[J]. Oncology(Williston Park), 2013,27(6):548-556.