TK1联合CA125、HE4在上皮性卵巢良恶性肿瘤早期诊断中的意义
|
摘要
目的研究胸苷激酶1(TK1)、糖类抗原125(CA125)和人附睾分泌蛋白4(HE4)在上皮性卵巢良恶性肿瘤早期诊断中的意义和价值。方法选取我院经手术及术后病理检查确诊为卵巢癌患者300例作为研究对象。病理检查确诊为ECO患者174例,其中Ⅰ期19例、Ⅱ期37例、Ⅲ期89例、Ⅳ期30例,卵巢良性肿瘤126例。选取同期体检健康者100例作为对照组。结果与卵巢良性肿瘤组、对照组相比,ECO组的TK1、CA125和HE4差异有统计学意义(P<0.05);卵巢良性肿瘤组与对照组相比,仅HE4差异有统计学意义(P<0.05);ECO组的手术病理分期结果表明Ⅲ期、Ⅳ期与Ⅰ期、Ⅱ期相比,TK1、CA125和HE4差异有统计学意义(P<0.05);TK1、CA125、HE4及TK1+CA125+HE4的曲线下面积分别是0.830、0.674、0.767和0.907。结论联合TK1、HE4和CA125能够提高EOC检出率,为ECO的早期筛查和诊断提供一定的实验基础和临床价值。
Objective To study the significance and value of thymidine kinase 1 combined with carbohydrate antigen 125 and human epididymis secretory protein 4 in the early diagnosis of epithelial ovarian benign and malignant tumors.Methods 300 patients with ovarian cancer diagnosed by surgery and postoperative pathological examination were selected.A total of 174 patients with ECO were diagnosed by pathological examination,including 19 cases of stageⅠ,37 cases of stage II,89 cases of stage Ⅲ,and 30 cases of stage Ⅳ.126 cases were benign ovarian tumors.100 healthy subjects of the same physical examination were selected as the control group.Results Compared with the ovarian benign tumor group and the control group,the TK1,CA125 and HE4 of the ECO group were statistically different(P<0.05).Comparing with the control group,only the HE4 was statistically different(P<0.05).The pathological staging results of ECO group showed statistical differences between TK1,CA125 and HE4 in III and IV compared with I and Ⅱ(P< 0.05).The ROC curve analysis results showed that area under the curves of TK1,CA125,HE4 and TK1+CA125+HE4 were respectively 0.830,0.674,0.767 and 0.907.Conclusion Combined with TK1,HE4 and CA125 can improve the detection rate of EOC,and provide certain experimental basis and clinical value for early screening and diagnosis of ECO.
Objective To study the significance and value of thymidine kinase 1 combined with carbohydrate antigen 125 and human epididymis secretory protein 4 in the early diagnosis of epithelial ovarian benign and malignant tumors.Methods 300 patients with ovarian cancer diagnosed by surgery and postoperative pathological examination were selected.A total of 174 patients with ECO were diagnosed by pathological examination,including 19 cases of stageⅠ,37 cases of stage II,89 cases of stage Ⅲ,and 30 cases of stage Ⅳ.126 cases were benign ovarian tumors.100 healthy subjects of the same physical examination were selected as the control group.Results Compared with the ovarian benign tumor group and the control group,the TK1,CA125 and HE4 of the ECO group were statistically different(P<0.05).Comparing with the control group,only the HE4 was statistically different(P<0.05).The pathological staging results of ECO group showed statistical differences between TK1,CA125 and HE4 in III and IV compared with I and Ⅱ(P< 0.05).The ROC curve analysis results showed that area under the curves of TK1,CA125,HE4 and TK1+CA125+HE4 were respectively 0.830,0.674,0.767 and 0.907.Conclusion Combined with TK1,HE4 and CA125 can improve the detection rate of EOC,and provide certain experimental basis and clinical value for early screening and diagnosis of ECO.
引文
[1] 任明达,刘树学,唐玉德,等.卵巢肿瘤定性诊断及卵巢癌术前分期:MRI与病理对照研究[J].中国CT和MRI杂志,2015(4):87-90.
[2] Wei Yi-tong,Luo Yu-zhong,Feng Zhi-qiang,et al.TK1 overexpression is associated with the poor outcomes of lung cancer patients:a systematic review and meta-analysis[J].Biomarkers in Medicine,2018,12(4):403-413.
[3] 林仲秋,吴妙芳,李晶,等.《FIGO 2015妇癌报告》解读连载三——卵巢癌、输卵管癌、腹膜癌诊治指南解读[J].中国实用妇科与产科杂志,2015,12:1074-1081.
[4] Xi Q-p,Pu D-h,Lu W-n.Research on application value of combined detection of serum CA125,HE4 and TK1 in the diagnosis of ovarian cancer[J].European Review for Medical and Pharmacological Sciences,2017,21(20):4536-4541.
[5] 宋坤,孔北华.上皮性卵巢癌的临床研究进展[J].现代妇产科进展,2013,22(7):527-533.
[6] Prader S,Vollmar N,Du Bois A,et al.Pattern and impact of metastatic cardiophrenic lymph nodes in advanced epithelial ovarian cancer[J].Gynecologic Oncology,2019,152(1):76-81.
[7] 张艳.复发性卵巢癌诊疗进展[J].中华实用诊断与治疗杂志,2013,27(10):942-943.
[8] Jagarlamudi K K,Hansson L O,Eriksson S.Breast and prostate cancer patients differ significantly in their serum Thymidine kinase 1 (TK1) specific activities compared with those hematological malignancies and blood donors:implications of using serum TK1 as a biomarker[J].BMC Cancer,2015,15:66.
[9] Schummer M,Drescher C,Forrest R,et al.Evaluation of ovarian cancer remission markers HE4,MMP7 and Mesothelin by comparison to the established marker CA125[J].Gynecologic Oncology,2012,125(1):65-69.
[10] James NE,Cantillo E,Oliver MT,et al.HE4 suppresses the expression of osteopontin in mononuclear cells and compromises their cytotoxicity against ovarian cancer cells[J].Clinical and Experimental Immunology,2018,193(3):327-340.
[11] Blyuss O,Burnell M,Ryan A,et al.Comparison of longitudinal CA125 algorithms as a First-Line screen for ovarian cancer in the general population[J].Clinical Cancer Research,2018,24(19):4726-4733.
[12] Chen Fa-wen,Shen Jing,Wang Jian-wei,et al.Clinical analysis of four serum tumor markers in 458 patients with ovarian tumors:diagnostic value of the combined use of HE4,CA125,CA19-9,and CEA in ovarian tumors[J].Cancer Management and Research,2018,10:1313-1318.
[13] Moro F,Pasciuto T,Djokovic D,et al.Role of CA125/CEA ratio and ultrasound parameters in identifying metastases to the ovaries in patients with multilocular and multilocular-solid ovarian masses[J].Ultrasound in Obstetrics & Gynecology,2019,53(1):116-123.
[2] Wei Yi-tong,Luo Yu-zhong,Feng Zhi-qiang,et al.TK1 overexpression is associated with the poor outcomes of lung cancer patients:a systematic review and meta-analysis[J].Biomarkers in Medicine,2018,12(4):403-413.
[3] 林仲秋,吴妙芳,李晶,等.《FIGO 2015妇癌报告》解读连载三——卵巢癌、输卵管癌、腹膜癌诊治指南解读[J].中国实用妇科与产科杂志,2015,12:1074-1081.
[4] Xi Q-p,Pu D-h,Lu W-n.Research on application value of combined detection of serum CA125,HE4 and TK1 in the diagnosis of ovarian cancer[J].European Review for Medical and Pharmacological Sciences,2017,21(20):4536-4541.
[5] 宋坤,孔北华.上皮性卵巢癌的临床研究进展[J].现代妇产科进展,2013,22(7):527-533.
[6] Prader S,Vollmar N,Du Bois A,et al.Pattern and impact of metastatic cardiophrenic lymph nodes in advanced epithelial ovarian cancer[J].Gynecologic Oncology,2019,152(1):76-81.
[7] 张艳.复发性卵巢癌诊疗进展[J].中华实用诊断与治疗杂志,2013,27(10):942-943.
[8] Jagarlamudi K K,Hansson L O,Eriksson S.Breast and prostate cancer patients differ significantly in their serum Thymidine kinase 1 (TK1) specific activities compared with those hematological malignancies and blood donors:implications of using serum TK1 as a biomarker[J].BMC Cancer,2015,15:66.
[9] Schummer M,Drescher C,Forrest R,et al.Evaluation of ovarian cancer remission markers HE4,MMP7 and Mesothelin by comparison to the established marker CA125[J].Gynecologic Oncology,2012,125(1):65-69.
[10] James NE,Cantillo E,Oliver MT,et al.HE4 suppresses the expression of osteopontin in mononuclear cells and compromises their cytotoxicity against ovarian cancer cells[J].Clinical and Experimental Immunology,2018,193(3):327-340.
[11] Blyuss O,Burnell M,Ryan A,et al.Comparison of longitudinal CA125 algorithms as a First-Line screen for ovarian cancer in the general population[J].Clinical Cancer Research,2018,24(19):4726-4733.
[12] Chen Fa-wen,Shen Jing,Wang Jian-wei,et al.Clinical analysis of four serum tumor markers in 458 patients with ovarian tumors:diagnostic value of the combined use of HE4,CA125,CA19-9,and CEA in ovarian tumors[J].Cancer Management and Research,2018,10:1313-1318.
[13] Moro F,Pasciuto T,Djokovic D,et al.Role of CA125/CEA ratio and ultrasound parameters in identifying metastases to the ovaries in patients with multilocular and multilocular-solid ovarian masses[J].Ultrasound in Obstetrics & Gynecology,2019,53(1):116-123.