HE4联合HMGB1、CA125在上皮性卵巢癌早期诊断中的应用

发布时间：2018-06-03 22:07

  本文选题：HE4 + HMGB1　； 参考：《青岛大学》2014年硕士论文

【摘要】：目的：探讨HE4、HMGB1、CA125三种肿瘤标志物与上皮性卵巢癌早期诊断及临床病理特征之间的关系,以探究三者在上皮性卵巢癌诊断中的意义。 方法：收集150例因卵巢肿物入院手术的病人,包括上皮性卵巢癌32例、卵巢良性肿瘤79例、卵巢巧克力囊肿患者39例,检测其血清HE4、HMGB1、CA125水平,以及45例健康体检者血清HE4、HMGB1、CA125水平。采用SPSS16.0软件处理数据并制作ROC曲线。 结果：1.卵巢癌组的血清HE4(198pmol/L)、HMGB1(220.25ug/ml)、CA125(250.5U/mL)均高于健康体检组、卵巢良性肿瘤组、卵巢巧克力囊肿组。HE4特异性(98.5%)显著高于CA125(75.3%),敏感性(76.7%)高于CA125(70%),血清HMGB1敏感性较高(78.2%),特异度较低(61.5%)。联合检测三种标志物灵敏度显著提高,约为95%,特异度接近100%。2.绝经前后健康女性及卵巢良性肿瘤患者HE4、HMGB1水平并无明显差别,而CA125存在一定差异。而对于上皮性卵巢癌患者,绝经后患者的HE4、HMGB1、CA125水平均较绝经前更高。卵巢巧克力囊肿组,未收集到绝经后卵巢巧克力囊肿病例。3.卵巢浆液性囊腺癌血清HE4水平最高(约为464.5pmoL/L), CA125水平也最高(约为548.5U/mL),血清HMGB1水平在各种病理分型的卵巢癌间差异无统计学意义(P=0.712)。晚期卵巢癌(包括Ⅲ期、Ⅳ期)血清HE4(264.4pmoL/L)、HMGB1(245.2ug/ml)、CA125(353.6U/mL)高于早期卵巢癌(包括Ⅰ期、Ⅱ期)血清HE4(94.8pmoL/L)、HMGB1(172.8ug/ml)、CA125(86.5U/mL)。三者联合检测的ROC曲线下面积AUC较单独检测更大。 结论：1.联合检测血清HE4、HMGB1、CA125在早期诊断上皮性卵巢癌的诊断中有更准确的提示作用。2.联合检测血清HE4、HMGB1、CA125在区别卵巢子宫内膜异位症和卵巢恶性肿瘤方面有重要作用。3.血清HE4、HMGB1、CA125水平可以作为评估卵巢癌患者疾病进展及判读预后的重要指标。
[Abstract]:Objective: to explore the relationship between three tumor markers, early diagnosis and clinicopathological features of epithelial ovarian cancer (EOC) and their significance in the diagnosis of epithelial ovarian cancer (EOC). Methods: the serum levels of HMGB1CA125 in 150 patients with ovarian neoplasms, including 32 epithelial ovarian cancer, 79 benign ovarian tumors and 39 ovarian chocolate cysts, were measured, and the serum levels of HE4HMGB1 and CA125 were measured in 45 healthy controls. SPSS16.0 software is used to process data and make ROC curve. The result is 1: 1. The serum levels of HMGB1) in ovarian cancer group were significantly higher than those in healthy control group (P < 0.05). The specificity of HE4 in ovarian benign tumor group and ovarian chocolate cyst group was significantly higher than that in CA1250.75% (sensitivity 76.7%). The sensitivity of serum HMGB1 was 78.2% and 61.5% higher than that of CA1257.The serum HMGB1 sensitivity of ovarian cancer group was higher than that of CA12570 (P < 0.05), and the sensitivity of serum HMGB1 was significantly higher than that of normal control group (P < 0.05). The sensitivity of serum HMGB1 was significantly higher than that of CA1257.The serum HMGB1 sensitivity was 78.2%, and the specificity was 61.5% higher than that in ovarian benign tumor group. The sensitivity of the combined detection of the three markers was significantly improved, about 95%, and the specificity was close to 100. 2. There was no significant difference in HMGB1 levels between healthy women and patients with benign ovarian tumors before and after menopause, but there was a certain difference in CA125. For epithelial ovarian cancer, the levels of HMGB1 CA125 in postmenopausal patients were higher than those in premenopausal women. Ovarian chocolate cyst group, no postmenopausal ovarian chocolate cyst case. 3. The serum HE4 level of ovarian serous cystadenocarcinoma was the highest (464.5 pmol / L), and the level of CA125 was the highest (about 548.5 U / mL). There was no significant difference in serum HMGB1 level among different pathological types of ovarian cancer. In advanced ovarian cancer (including stage 鈪，

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