YKL-40作为卵巢上皮性肿瘤标志物的初步研究

发布时间：2018-07-27 15:27

【摘要】：目的：探讨血清甲壳质酶蛋白40(YKL-40)作为卵巢上皮性肿瘤标志物的临床意义。方法：用酶联免疫吸附法（ELISA)测定2011年10月至2012年10月在广西医科大学第一附属医院住院治疗诊断为卵巢上皮性恶性肿瘤35例，交界性肿瘤13例，良性肿瘤27例及29例健康妇女血清中的YKL-40水平，比较血清YKL-40在4组间的差异，以及23例卵巢癌患者手术治疗前后YKL-40的变化。结果： 1、卵巢癌组患者血清中YKL-40水平显著高于健康组（P=0.000）、良性肿瘤组（P=0.000）和交界性肿瘤组（P=0.002）；而健康组与良性肿瘤组（P=0.235），健康组与交界性肿瘤组（P=0.499），良性肿瘤组与交界性肿瘤组（P=0.876）之间差异无统计学意义。 2、23例卵巢上皮性恶性肿瘤患者术前YKL-40水平显著高于术后3-7天水平（P=0.000）。 3、卵巢上皮性恶性肿瘤组与健康组评价YKL-40用于诊断卵巢上皮性恶性肿瘤的ROC曲线下面积为0.729。当选取YKL-40浓度138.50ug/L作为正常参考值临界点时，灵敏度和特异度分别为51.4%和91.3%，一致率为77.9%，Youden指数为0.43，阳性似然比为5.91，阴性似然比为0.53，阳性预测值为75.0%，，阴性预测值为78.8%。 4、术前卵巢癌患者血清YKL-40水平与手术病理分期、病理分级、盆腔淋巴结是否转移、血清CA125水平升高与否有关（P＜0.01），而与病理类型及术中腹腔冲洗液癌细胞检出率无关。结论：血清YKL-40作为卵巢上皮性肿瘤标志物有一定的临床价值。
[Abstract]:Objective: to investigate the clinical significance of serum chitin 40 (YKL-40) as a marker of ovarian epithelial tumor. Methods: from October 2011 to October 2012, 35 cases of epithelial ovarian neoplasms and 13 cases of borderline tumors were detected by enzyme linked immunosorbent assay (ELISA) in the first affiliated Hospital of Guangxi Medical University. The serum YKL-40 levels of 27 benign tumors and 29 healthy women were compared between the four groups, and the changes of YKL-40 in 23 patients with ovarian cancer before and after operation were compared. Results: 1 the serum YKL-40 level in ovarian cancer group was significantly higher than that in healthy group (P0. 000), benign tumor group (P0. 000) and borderline tumor group (P0. 002). But there was no significant difference between healthy group and benign tumor group (P0. 235), healthy group and borderline tumor group (P0. 499), benign tumor group and borderline tumor group (P0. 876). The area under the ROC curve of evaluating YKL-40 for diagnosis of ovarian epithelial malignant tumor was 0.729 in the group of ovarian epithelial malignant tumor and healthy group, which was higher than the level of 3 to 7 days postoperatively (P0. 000). When YKL-40 concentration 138.50ug/L is selected as the critical point of normal reference value, The sensitivity and specificity were 51.4% and 91.3%, respectively. The concordance rate was 77.9%. The Youden index was 0.43, the positive likelihood ratio was 5.91, the negative likelihood ratio was 0.53, the positive predictive value was 75.0 and the negative predictive value was 78.80.The preoperative serum YKL-40 level of ovarian cancer patients was correlated with the surgical pathological stages. Pathological grade, metastasis of pelvic lymph nodes and elevation of serum CA125 level were related (P < 0. 01), but not related to pathological type and intraoperative detection rate of cancer cells in peritoneal lavage fluid. Conclusion: serum YKL-40 has some clinical value as ovarian epithelial tumor marker.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.31

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