血清CA724、CYFRA21-1及PIVKA-Ⅱ诊断卵巢癌价值
|
摘要
目的:探讨血清糖类抗原724(CA724)、细胞角蛋白19片断(CYFRA21-1)及异常凝血酶原(PIVKA-Ⅱ)在诊断卵巢癌的应用价值。方法:选取本院肿瘤科收治的卵巢癌患者46例作为卵巢癌组,卵巢良性肿瘤患者50例为良性肿瘤组,健康体检50例为健康对照组,采用化学发光法检测血清CA724、CYFRA21-1、PIVKA-Ⅱ水平,绘制受试者工作者特征曲线(AUC)比较分析。结果:血清CA724、CYFRA21-1、PIVKA-Ⅱ水平及组内阳性率卵巢癌组>良性肿瘤组>对照组(P<0.05);CA724的AUC为0.845,诊断敏感性为72.1%,特异性为87.9%;CYFRA21-1的AUC为0.813,诊断敏感性为67.4%,特异性为83.5%;PIVKA-Ⅱ的AUC为0.729,临界值为>24.74 U/L,诊断敏感性为61.4%,特异性为91.0%;CA724+CYFRA21-1、CA724+PIVKA-Ⅱ、CYFRA21-1+PIVKA-Ⅱ两两联合诊断卵巢癌的阳性率均较高(81.6%、82.6%、82.2%),但CA724+CYFRA21-1检测灵敏度、诊断准确率高于其他两组,3项指标联合检测的灵敏度、阳性率、诊断准确率最高,且特异性未见明显降低。结论:血清CA724、CYFRA21-1、PIVKA-Ⅱ对卵巢癌具有较高的辅助诊断价值,且三者联合检测可提高卵巢癌阳性检出率。
Objective: To investigate the value of serum levels of carbohydrate antigen 724(CA724), cytokeratin 19 fragment(CYFRA21-1) and abnormal prothrombin(PIVKA-II) for diagnosing patients with ovarian cancer. Methods: 46 patients with ovarian cancer were selected in study group, 50 patients with benign ovarian tumor were selected in control group, and 50 healthy women were elected in healthy control group. The levels of serum CA724, CYFRA21-1 and PIVKA-II were detected by chemiluminescence. The area under curve(AUC) of receiver operator characteristic was used for analyzing the value of levels of serum CA724, CYFRA21-1 and PIVKA-II. Results: The levels of serum CA724, CYFRA21-1 and PIVKA-II of patients in study group were the highest among the three groups, but were the lowest in healthy control group(P<0.05).The value of AUC, the sensitivity and the specificity of CA724 level were 0.845, 72.1%, and 87.9%, respectively, the value of AUC, the sensitivity and the specificity of CYFRA21-1 level were 0.813, 67.4%, and 83.5%, respectively, and the value of AUC, the sensitivity and the specificity of PIVKA-II were 0.729, 61.4%, and 91.0%,respectively.The critical value of CYFRA21-1 level was over 24.74 U/L. And the diagnosis positive rates of A724 level combined with CYFRA21-1 level, CA724 level combined with PIVKA-II level, CYFRA21-1 level combined with PIVKA-II level combined detections were 81.6%, 82.6%, and 82.2%,respectively.The sensitivity and accuracy of CA724 level combined with CYFRA21-1 level were higher than those of CA724 level combined with PIVKA-II level or CYFRA21-1 level combined with PIVKA-II level. The sensitivity, positive rate and diagnostic accuracy of the combination of CA724 level, CYFRA21-1 level and PIVKA-II level had increased significantly,
Objective: To investigate the value of serum levels of carbohydrate antigen 724(CA724), cytokeratin 19 fragment(CYFRA21-1) and abnormal prothrombin(PIVKA-II) for diagnosing patients with ovarian cancer. Methods: 46 patients with ovarian cancer were selected in study group, 50 patients with benign ovarian tumor were selected in control group, and 50 healthy women were elected in healthy control group. The levels of serum CA724, CYFRA21-1 and PIVKA-II were detected by chemiluminescence. The area under curve(AUC) of receiver operator characteristic was used for analyzing the value of levels of serum CA724, CYFRA21-1 and PIVKA-II. Results: The levels of serum CA724, CYFRA21-1 and PIVKA-II of patients in study group were the highest among the three groups, but were the lowest in healthy control group(P<0.05).The value of AUC, the sensitivity and the specificity of CA724 level were 0.845, 72.1%, and 87.9%, respectively, the value of AUC, the sensitivity and the specificity of CYFRA21-1 level were 0.813, 67.4%, and 83.5%, respectively, and the value of AUC, the sensitivity and the specificity of PIVKA-II were 0.729, 61.4%, and 91.0%,respectively.The critical value of CYFRA21-1 level was over 24.74 U/L. And the diagnosis positive rates of A724 level combined with CYFRA21-1 level, CA724 level combined with PIVKA-II level, CYFRA21-1 level combined with PIVKA-II level combined detections were 81.6%, 82.6%, and 82.2%,respectively.The sensitivity and accuracy of CA724 level combined with CYFRA21-1 level were higher than those of CA724 level combined with PIVKA-II level or CYFRA21-1 level combined with PIVKA-II level. The sensitivity, positive rate and diagnostic accuracy of the combination of CA724 level, CYFRA21-1 level and PIVKA-II level had increased significantly,
引文
[1] Swiatly A, Horala A, Hajduk J, et al. MALDI-TOF-MS analysis in discovery and identification of serum proteomic patterns of ovarian cancer[J]. Bmc Cancer, 2017, 17(1):472-451.
[2] Matsumoto Y, Miwa S, Zhang Y, et al. Intraperitoneal administration of tumor-targeting Salmonella typhimurium A1-R inhibits disseminated human ovarian cancer and extends survival in nude mice[J]. Oncotarget, 2015, 6(13):11369-11377.
[3] 李载红,景香香,陈银,等.彩超联合血清CA125、CA724对卵巢良恶性肿瘤鉴别诊断的意义[J].中国临床医学影像杂志,2016,27(06):416-418.
[4] 冷丽丽, 谷梅华. 血清HE4、CYFRA21-1、CA199在诊断卵巢良、恶性肿瘤中的价值[J]. 国际肿瘤学杂志, 2015, 42(9):657.
[5] Akutsu N, Adachi Y, Isosaka M, et al. Mediastinal Yolk Sac Tumor Producing Protein Induced by Vitamin K Absence or Antagonist-II[J]. Intern Med, 2015, 54(12):1531-1536.
[6] 谢辛, 孔北华, 段涛. 妇产科学.第9版[M]. 北京: 人民卫生出版社, 2018:326-331.
[7] Monk B J, Poveda A, Vergote I, et al. Anti-angiopoietin therapy with trebananib for recurrent ovarian cancer (TRINOVA-1): a randomised, multicentre, double-blind, placebo-controlled phase 3 trial[J]. Lancet Oncology, 2015, 15(8):799-808.
[8] 冯利,杨欣慰,李晓兰.联合检测血清癌抗原724及甲胎蛋白在卵巢癌诊断、临床分期中的价值[J].现代肿瘤医学,2017,25(12):1967-1970.
[9] 朱幼鸣, 卢振, 张卫卫. 联合检测癌胚抗原、糖类抗原724在结直肠癌诊断中的应用价值[J]. 国际检验医学杂志, 2017, 38(13):1822-1824.
[10] 吕晓梅,陈涛,张小强,等.血清HE4、CA125、CA199、CA724联合检测对卵巢癌早期诊断的临床价值探讨[J].国际检验医学杂志,2016,37(09):1274-1276.
[11] 张红.人附睾蛋白4联合CA199、CA724检测诊断卵巢癌的价值[J].中国妇幼保健,2017,32(15):3482-3485.
[12] Nisman B, Lafair J, Heching N, et al. Evaluation of tissue polypeptide specific antigen, CYFRA 21-1, and carcinoembryonic antigen in nonsmall cell lung carcinoma: does the combined use of cytokeratin markers give any additional information?[J]. Cancer, 2015, 82(10):1850-1859.
[13] 赘彦泽, 谢波. 血清细胞角蛋白19片段21-1及鳞状细胞癌相关抗原联合检测对鼻咽癌的诊断价值[J]. 肿瘤研究与临床, 2016, 28(5):331-333.
[14] 花枝俏, 孙庆娥, 张建忠,等. HE4、CA125、CA72-4、CA153、CA19-9、CYFRA21-1、TSH在卵巢癌诊断中的评价[J]. 中国保健营养, 2017, 27(16):138-142.
[15] 冯晓丹, 叶莉莉, 高玲娟,等. 联合检测CA125、CYFRA21-1及D-dimer对卵巢癌早期筛查与诊断的应用价值[J]. 中国卫生检验杂志, 2015,25(20):3512-3513.
[16] 王堃, 喻晶. 异常凝血酶原(PIVKA-Ⅱ)对结直肠癌的辅助诊断价值[J]. 中国肿瘤, 2017, 26(2):152-155.
[17] 雷旦生, 喻晶. 血清异常凝血酶原水平在胰腺癌诊治中的应用价值[J]. 中华胰腺病杂志, 2016, 16(4):217-220.
[18] 马丽娜, 王维琴. 卵巢肿瘤标志物的研究进展[J]. 内蒙古医学杂志, 2016, 48(2):183-186.
[2] Matsumoto Y, Miwa S, Zhang Y, et al. Intraperitoneal administration of tumor-targeting Salmonella typhimurium A1-R inhibits disseminated human ovarian cancer and extends survival in nude mice[J]. Oncotarget, 2015, 6(13):11369-11377.
[3] 李载红,景香香,陈银,等.彩超联合血清CA125、CA724对卵巢良恶性肿瘤鉴别诊断的意义[J].中国临床医学影像杂志,2016,27(06):416-418.
[4] 冷丽丽, 谷梅华. 血清HE4、CYFRA21-1、CA199在诊断卵巢良、恶性肿瘤中的价值[J]. 国际肿瘤学杂志, 2015, 42(9):657.
[5] Akutsu N, Adachi Y, Isosaka M, et al. Mediastinal Yolk Sac Tumor Producing Protein Induced by Vitamin K Absence or Antagonist-II[J]. Intern Med, 2015, 54(12):1531-1536.
[6] 谢辛, 孔北华, 段涛. 妇产科学.第9版[M]. 北京: 人民卫生出版社, 2018:326-331.
[7] Monk B J, Poveda A, Vergote I, et al. Anti-angiopoietin therapy with trebananib for recurrent ovarian cancer (TRINOVA-1): a randomised, multicentre, double-blind, placebo-controlled phase 3 trial[J]. Lancet Oncology, 2015, 15(8):799-808.
[8] 冯利,杨欣慰,李晓兰.联合检测血清癌抗原724及甲胎蛋白在卵巢癌诊断、临床分期中的价值[J].现代肿瘤医学,2017,25(12):1967-1970.
[9] 朱幼鸣, 卢振, 张卫卫. 联合检测癌胚抗原、糖类抗原724在结直肠癌诊断中的应用价值[J]. 国际检验医学杂志, 2017, 38(13):1822-1824.
[10] 吕晓梅,陈涛,张小强,等.血清HE4、CA125、CA199、CA724联合检测对卵巢癌早期诊断的临床价值探讨[J].国际检验医学杂志,2016,37(09):1274-1276.
[11] 张红.人附睾蛋白4联合CA199、CA724检测诊断卵巢癌的价值[J].中国妇幼保健,2017,32(15):3482-3485.
[12] Nisman B, Lafair J, Heching N, et al. Evaluation of tissue polypeptide specific antigen, CYFRA 21-1, and carcinoembryonic antigen in nonsmall cell lung carcinoma: does the combined use of cytokeratin markers give any additional information?[J]. Cancer, 2015, 82(10):1850-1859.
[13] 赘彦泽, 谢波. 血清细胞角蛋白19片段21-1及鳞状细胞癌相关抗原联合检测对鼻咽癌的诊断价值[J]. 肿瘤研究与临床, 2016, 28(5):331-333.
[14] 花枝俏, 孙庆娥, 张建忠,等. HE4、CA125、CA72-4、CA153、CA19-9、CYFRA21-1、TSH在卵巢癌诊断中的评价[J]. 中国保健营养, 2017, 27(16):138-142.
[15] 冯晓丹, 叶莉莉, 高玲娟,等. 联合检测CA125、CYFRA21-1及D-dimer对卵巢癌早期筛查与诊断的应用价值[J]. 中国卫生检验杂志, 2015,25(20):3512-3513.
[16] 王堃, 喻晶. 异常凝血酶原(PIVKA-Ⅱ)对结直肠癌的辅助诊断价值[J]. 中国肿瘤, 2017, 26(2):152-155.
[17] 雷旦生, 喻晶. 血清异常凝血酶原水平在胰腺癌诊治中的应用价值[J]. 中华胰腺病杂志, 2016, 16(4):217-220.
[18] 马丽娜, 王维琴. 卵巢肿瘤标志物的研究进展[J]. 内蒙古医学杂志, 2016, 48(2):183-186.