Finkler超声评分联合HE4、miR-21在上皮性卵巢癌诊断中的价值
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摘要
目的探究Finkler超声评分联合血清人附睾蛋白4(HE4)、微小RNA-21(miR-21)在上皮性卵巢癌中的临床价值。方法收集96例上皮性卵巢癌患者(恶性组)、80例上皮性卵巢良性治疗患者(良性组)进行研究,所有受试者均进行超声检测,参照Finkler超声评分法对肿瘤情况进行评估,酶联免疫法(ELISA)对血清中HE4水平进行检测,荧光定量PCR(QPCR)检测外周血miR-21表达,以病理结果作为金标准,对比患者Finkler超声评分、HE4、miR-21单项检测以及三项联合检测诊断效能。结果恶性组Finkler评分以及阳性率,HE4水平、阳性检出率,miR-21 mRNA表达量均高于良性组,差异有统计学意义(P<0.05)。受试者工作特征(ROC)曲线分析显示miR-21诊断上皮性卵巢癌ROC曲线下面积(AUC)为0.858(95%CI:0.770～0.921,P<0.05),截断值为1.73,此时敏感度为77.08%,特异度为81.25%。Finkler评分敏感度78.13%,特异度为80.00%,准确度为78.98%,HE4敏感度为72.92%,特异度为85.00%,准确度为78.41%。与单项检测相比,联合检测在上皮性卵巢癌中的准确度、敏感度均升高(P<0.05)。与单项检测相比,Ⅰ～Ⅱ期联合检测准确度、敏感度均升高(P<0.05)。结论 Finkler超声评分在上皮性卵巢癌中诊断效能较好,联合血清HE4、miR-21后诊断效能进一步提高,为临床上皮性卵巢癌诊断提供一定的参考。
Objective To investigate the diagnostic significance of Finkler ultrasound score combined with serum human epididymis 4(HE4) and micro RNA-21(miR-21) in epithelial ovarian cancer. Methods Ninty-six cases of epithelial ovarian cancer(malignant group) and 80 cases of benign epithelial ovarian tumors(benign group) were collected. All subjects were examined by ultrasound. The tumor condition was assessed with reference to Finkler ultrasound score. Enzyme linked immunosorbent assay(ELISA) was used to detect the level of HE4 in serum, and fluorescence quantitative PCR(QPCR) was used to detect the expression of miR-21 in peripheral blood. The pathological results were applied as the gold standard. Results The Finkler score and positive rate, HE level and positive detection rate, and miR-21 mRNA expression level in malignant group were significantly higher than those in benign group(P<0.05). ROC curve analysis showed that AUC of miR-21 in the diagnosis of epithelial ovarian cancer was 0.858(95%CI:0.770-0.921, P<0.05), the cut-off value was 1.73, the sensitivity was 77.08%, and the specificity was 81.25%. The sensitivity, specificity and accuracy of Finkler score were 78.13%, 80.00% and 78.98%, respectively; and the sensitivity, specificity and accuracy of HE were 72.92%, 85.00%, and 78.41%, respectively. Compared with single detection, the accuracy and sensitivity of combined detection in epithelial ovarian cancer were significantly increased(P<0.05). Conclusion The diagnostic efficacy of Finkler ultrasound score in epithelial ovarian cancer is better, the diagnostic efficiency of combined serum HE4 and miR-21 is further improved, which provides a certain reference for the clinical diagnosis of epithelial ovarian cancer.
Objective To investigate the diagnostic significance of Finkler ultrasound score combined with serum human epididymis 4(HE4) and micro RNA-21(miR-21) in epithelial ovarian cancer. Methods Ninty-six cases of epithelial ovarian cancer(malignant group) and 80 cases of benign epithelial ovarian tumors(benign group) were collected. All subjects were examined by ultrasound. The tumor condition was assessed with reference to Finkler ultrasound score. Enzyme linked immunosorbent assay(ELISA) was used to detect the level of HE4 in serum, and fluorescence quantitative PCR(QPCR) was used to detect the expression of miR-21 in peripheral blood. The pathological results were applied as the gold standard. Results The Finkler score and positive rate, HE level and positive detection rate, and miR-21 mRNA expression level in malignant group were significantly higher than those in benign group(P<0.05). ROC curve analysis showed that AUC of miR-21 in the diagnosis of epithelial ovarian cancer was 0.858(95%CI:0.770-0.921, P<0.05), the cut-off value was 1.73, the sensitivity was 77.08%, and the specificity was 81.25%. The sensitivity, specificity and accuracy of Finkler score were 78.13%, 80.00% and 78.98%, respectively; and the sensitivity, specificity and accuracy of HE were 72.92%, 85.00%, and 78.41%, respectively. Compared with single detection, the accuracy and sensitivity of combined detection in epithelial ovarian cancer were significantly increased(P<0.05). Conclusion The diagnostic efficacy of Finkler ultrasound score in epithelial ovarian cancer is better, the diagnostic efficiency of combined serum HE4 and miR-21 is further improved, which provides a certain reference for the clinical diagnosis of epithelial ovarian cancer.
引文
[1] 李芬琴.新辅助化疗治疗晚期上皮性卵巢癌的研究进展[J].实用妇产科杂志,2017,33(7):502-505.
[2] 李秀琴,王欣彦.上皮性卵巢癌精准治疗研究进展[J].中国实用妇科与产科杂志,2016,32(8):810-813.
[3] 先君,郭舟群,王英红.人附睾蛋白4在妇科良性疾病中的评估作用研究[J].中国全科医学,2016,19(14):1667-1671.
[4] 刘德春,娄艳辉,王灵芝,等.沉默miR-21表达对顺铂耐药卵巢上皮性癌细胞耐药性的影响及其机制研究[J].中华妇产科杂志,2016,51(4):300-303.
[5] Benedet JL,Bender H,Ngan HY,et al.FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers.FIGO Committee on Gynecologic Oncology[J].Int J Gynaecol Obstet,2000,70(2):209-262.
[6] Finkler Nl,Benacerraf Bl,Lavin P,et al.Comparison of serum CAl25,clinical impression and ultrasound in the preoperative evaluation of ovarian masses[J].Obstet Gynecol,1988,72(3):659-664.
[7] 梁培丽,张莘,徐国才,等.青少年女性卵巢上皮性肿瘤50例临床分析[J].中国妇产科临床杂志,2016,48(4):305-308.
[8] 白萍,舒桐,孙慧.靶向治疗对复发性耐药性卵巢癌的治疗价值[J].中国实用妇科与产科杂志,2015,31(3):211-216.
[9] 胥琳璟,刘国江,欧丽红,等.卵巢癌患者经阴道彩色多普勒血流特征分析及对肿瘤恶性程度的评估价值[J].海南医学院学报,2016,22(5):503-505.
[10] 钱林华,高燕,李惠东,等.超声联合CA125、CA199诊断早期上皮性卵巢癌的临床价值[J].天津医科大学学报,2010,16(3):502-505.
[11] 陈铃,袁颂华,石小红.恶性风险指数、超声特征及CA125对上皮性卵巢癌的预测价值[J].暨南大学学报:自然科学与医学版,2012,33(6):633-637.
[12] 孔海霞,李洪娟,徐婧玥,等.肺癌患者血清MMP-9、HE4、CYFRA21-1、CEA、NSE水平变化及其临床意义[J].山东医药,2017,57(32):73-75.
[13] 王强,陈传艳,王东生,等.血清HE4、CEA、NSE和Cyfra21-1联合检测在肺癌中的诊断价值[J].重庆医学,2017,46(26):3721-3722.
[14] 於永爱,金仙玉.HE4、Sp1在上皮性卵巢癌中的表达及其临床意义[J].中国妇产科临床杂志,2016,48(5):391-394.
[15] 徐登诚,刘宝瑞,沈洁.胃癌组织和循环miR-21与胃癌伊立替康敏感性关系的初步研究[J].中国癌症杂志,2013,23(9):744-750.
[16] 王贵年,吴娟.miR-21在乳腺癌患者血清中的表达及意义[J].医学研究杂志,2014,43(3):126-128.
[17] 郑文静,胡晓霞.miR-21与宫颈癌关系的研究进展[J].广西医学,2014,36(4):484-487.
[18] Nam EJ,Yoon H,Kim SW,et al.MICRORNA expression profiles inserous ovarian carcinoma[J].Clin Cancer Res,2008,14(9):2690-2695.
[19] 马卓娅,汤华,李欣,等.MicroRNA在6种肿瘤细胞中的表达差异[J].中国肿瘤生物治疗杂志,2007,14(3):254-258.
[20] 张丹,柳英兰,刘学宁.超超声评分系统结合血清附睾分泌蛋白4、CA125对卵巢肿瘤的诊断意义[J].武警医学,2014,25(12):1242-1244.
[21] 欧红萍,黄艳丽.彩超评分、血流阻力指数及CA125在卵巢肿瘤良恶性鉴别诊断中的意义[J].临床和实验医学杂志,2015,14(7):595-598.
[2] 李秀琴,王欣彦.上皮性卵巢癌精准治疗研究进展[J].中国实用妇科与产科杂志,2016,32(8):810-813.
[3] 先君,郭舟群,王英红.人附睾蛋白4在妇科良性疾病中的评估作用研究[J].中国全科医学,2016,19(14):1667-1671.
[4] 刘德春,娄艳辉,王灵芝,等.沉默miR-21表达对顺铂耐药卵巢上皮性癌细胞耐药性的影响及其机制研究[J].中华妇产科杂志,2016,51(4):300-303.
[5] Benedet JL,Bender H,Ngan HY,et al.FIGO staging classifications and clinical practice guidelines in the management of gynecologic cancers.FIGO Committee on Gynecologic Oncology[J].Int J Gynaecol Obstet,2000,70(2):209-262.
[6] Finkler Nl,Benacerraf Bl,Lavin P,et al.Comparison of serum CAl25,clinical impression and ultrasound in the preoperative evaluation of ovarian masses[J].Obstet Gynecol,1988,72(3):659-664.
[7] 梁培丽,张莘,徐国才,等.青少年女性卵巢上皮性肿瘤50例临床分析[J].中国妇产科临床杂志,2016,48(4):305-308.
[8] 白萍,舒桐,孙慧.靶向治疗对复发性耐药性卵巢癌的治疗价值[J].中国实用妇科与产科杂志,2015,31(3):211-216.
[9] 胥琳璟,刘国江,欧丽红,等.卵巢癌患者经阴道彩色多普勒血流特征分析及对肿瘤恶性程度的评估价值[J].海南医学院学报,2016,22(5):503-505.
[10] 钱林华,高燕,李惠东,等.超声联合CA125、CA199诊断早期上皮性卵巢癌的临床价值[J].天津医科大学学报,2010,16(3):502-505.
[11] 陈铃,袁颂华,石小红.恶性风险指数、超声特征及CA125对上皮性卵巢癌的预测价值[J].暨南大学学报:自然科学与医学版,2012,33(6):633-637.
[12] 孔海霞,李洪娟,徐婧玥,等.肺癌患者血清MMP-9、HE4、CYFRA21-1、CEA、NSE水平变化及其临床意义[J].山东医药,2017,57(32):73-75.
[13] 王强,陈传艳,王东生,等.血清HE4、CEA、NSE和Cyfra21-1联合检测在肺癌中的诊断价值[J].重庆医学,2017,46(26):3721-3722.
[14] 於永爱,金仙玉.HE4、Sp1在上皮性卵巢癌中的表达及其临床意义[J].中国妇产科临床杂志,2016,48(5):391-394.
[15] 徐登诚,刘宝瑞,沈洁.胃癌组织和循环miR-21与胃癌伊立替康敏感性关系的初步研究[J].中国癌症杂志,2013,23(9):744-750.
[16] 王贵年,吴娟.miR-21在乳腺癌患者血清中的表达及意义[J].医学研究杂志,2014,43(3):126-128.
[17] 郑文静,胡晓霞.miR-21与宫颈癌关系的研究进展[J].广西医学,2014,36(4):484-487.
[18] Nam EJ,Yoon H,Kim SW,et al.MICRORNA expression profiles inserous ovarian carcinoma[J].Clin Cancer Res,2008,14(9):2690-2695.
[19] 马卓娅,汤华,李欣,等.MicroRNA在6种肿瘤细胞中的表达差异[J].中国肿瘤生物治疗杂志,2007,14(3):254-258.
[20] 张丹,柳英兰,刘学宁.超超声评分系统结合血清附睾分泌蛋白4、CA125对卵巢肿瘤的诊断意义[J].武警医学,2014,25(12):1242-1244.
[21] 欧红萍,黄艳丽.彩超评分、血流阻力指数及CA125在卵巢肿瘤良恶性鉴别诊断中的意义[J].临床和实验医学杂志,2015,14(7):595-598.