探讨人乳头状病毒（HPV）与五种肿瘤标志物联合检测在宫颈癌早期诊断中的价值
发布时间：2018-08-11 10:59
【摘要】：目的:探讨HPV及AFP、CEA、CA199、CA125、SCC五种肿瘤标志物联合检测在宫颈癌早期诊断中的价值。方法:对本院2014年1月到2016年12月健康体检者124例,宫颈炎患者200例,以及本院此期间住院治疗的宫颈癌前病变患者59例以及宫颈癌患者32例,利用实时荧光定量PCR方法对宫颈分泌物中HPV进行检测,利用电化学发光免疫分析仪分别检测血清中AFP、CEA、CA199、CA125含量,利用微粒子酶免分析法检测血清中SCC含量;统计学方法采用SPSS19.0统计学处理软件进行数据分析,计量资料用(?)±s表示,组间比较采用t检验;计数资料用率表示,组间比较采用χ2检验;采用受试者工作曲线(ROC曲线)来评价AFP、CEA、CA199、CA125、SCC对宫颈癌诊断的价值。结果:1.本次研究共检出HPV亚型17种,其中检出率最高的HPV亚型为HPV16。2.本次研究表明宫颈癌前病变组、宫颈癌组HPV16检出率高于健康查体组和宫颈炎组,差异有统计学意义(p0.001)。3.本次研究表明各个年龄组HPV感染阳性率不完全相同,差异有统计学意义(p0.01)。4.宫颈癌组HPV检出阳性率明显高于健康查体、宫颈炎、癌前病变组,差异有统计学意意义(p0.001);癌前病变组明显高于宫颈炎组和健康查体组,差异有统计学意义(p0.001)。5.本次研究所有入选415人中共检出HPV单一感染115例,二重感染34例,多重感染3例,其中以HPV52型合并感染最常见,HPV感染仍然以单一亚型感染为主,多重感染仅占一小部分。6.宫颈癌组的AFP、CEA、CA125、CA199、SCC显著高于宫颈癌前病变组和正常对照组(P0.001),差异有统计学意义;宫颈癌前病变组CEA、CA125、CA199、SCC显著高于正常对照组(P0.001),差异有统计学意义;宫颈癌前病变组与正常对照组AFP比较无统计学差异(P0.05)。7.对宫颈癌组及正常对照组的个体进行AFP、CEA、CA125、CA199、SCC水平的检测,并分析单项、双项、三项、四项及五项联合检测对宫颈癌的诊断的价值,发现五项联合检测诊断的敏感性最高,与其他诊断方式相比有显著性差异(p0.05)。8.五种血清肿瘤标志物ROC曲线分析在宫颈癌的诊断中SCC曲线下面积比AFP、CEA、CA199、CA125更大,在宫颈癌诊断中具有较高的敏感性。其次为CA125。9.HPV及AFP、CEA、CA125、CA199、SCC联合检测敏感性高于单一检测HPV及单一检测五种肿瘤标志物。结论:HPV与五种肿瘤标志物联合检测可用于宫颈癌的早期诊断。
[Abstract]:Objective: to evaluate the value of combined detection of five tumor markers (HPV and AFPCEA CA125C) in early diagnosis of cervical cancer. Methods: from January 2014 to December 2016, 124 patients with cervical cancer, 200 patients with cervicitis, 59 patients with cervical precancerous lesions and 32 patients with cervical cancer were enrolled in our hospital. The HPV in cervical secretions was detected by real-time fluorescence quantitative PCR method. The content of SCC in serum was detected by electrochemiluminescence immunoassay (ECLIA) and microparticle enzyme immunoassay (PIA). SPSS19.0 software was used to analyze the data, the measurement data were expressed as (?) 卤s, and the t test was used for the comparison between groups, the rate of data used was expressed, the 蠂 2 test was used for the comparison between groups. The ROC curve was used to evaluate the value of ROC in the diagnosis of cervical cancer. The result is 1: 1. In this study, 17 HPV subtypes were detected, and the highest detection rate of HPV subtype was HPV16.2. This study showed that the positive rate of HPV16 in precancerous lesion group and cervical cancer group was higher than that in healthy check-up group and cervicitis group, the difference was statistically significant (p0. 001). 3. This study shows that the positive rate of HPV infection in all age groups is not exactly the same, the difference is statistically significant (p0.01). 4. The positive rate of HPV in cervical cancer group was significantly higher than that in healthy examination group, cervicitis group and precancerous lesion group (p0. 001), and the positive rate in precancerous lesion group was significantly higher than that in cervicitis group and healthy examination group (p0. 001). In this study, 115 cases of HPV single infection, 34 cases of double infection and 3 cases of multiple infection were detected in 415 subjects. Among them, the most common infection of HPV52 type co-infection was still single subtype infection, and multiple infection accounted for only a small part. The SCC of the cervical cancer group was significantly higher than that of the precancerous lesion group and the normal control group (P0.001), and the SCC of the cervical precancerous lesion group was significantly higher than that of the normal control group (P0.001), and the SCC of the cervical cancer group was significantly higher than that of the normal control group (P0.001). There was no significant difference in AFP between precancerous lesion group and normal control group (P0.05). The level of SCC in cervical cancer group and normal control group was detected by AFPG-CEACA125CA1999.The value of single, double, three, four and five combined tests in the diagnosis of cervical cancer was analyzed. The results showed that five combined tests were the most sensitive in the diagnosis of cervical cancer. Compared with other diagnostic methods, there was significant difference (p0.05). In the diagnosis of cervical cancer, the area under the SCC curve was larger than that of the AFP-CEACA199CA199CA125, and had a higher sensitivity in the diagnosis of cervical cancer by ROC curve analysis of five serum tumor markers. The sensitivity of combined detection of CA125.9.HPV and AFPCEA CA125 CA199C was higher than that of single detection of HPV and single detection of five tumor markers. Conclusion the combined detection of human papillomavirus (HPV) and five tumor markers can be used for early diagnosis of cervical cancer.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.33
本文编号：2176801
[Abstract]:Objective: to evaluate the value of combined detection of five tumor markers (HPV and AFPCEA CA125C) in early diagnosis of cervical cancer. Methods: from January 2014 to December 2016, 124 patients with cervical cancer, 200 patients with cervicitis, 59 patients with cervical precancerous lesions and 32 patients with cervical cancer were enrolled in our hospital. The HPV in cervical secretions was detected by real-time fluorescence quantitative PCR method. The content of SCC in serum was detected by electrochemiluminescence immunoassay (ECLIA) and microparticle enzyme immunoassay (PIA). SPSS19.0 software was used to analyze the data, the measurement data were expressed as (?) 卤s, and the t test was used for the comparison between groups, the rate of data used was expressed, the 蠂 2 test was used for the comparison between groups. The ROC curve was used to evaluate the value of ROC in the diagnosis of cervical cancer. The result is 1: 1. In this study, 17 HPV subtypes were detected, and the highest detection rate of HPV subtype was HPV16.2. This study showed that the positive rate of HPV16 in precancerous lesion group and cervical cancer group was higher than that in healthy check-up group and cervicitis group, the difference was statistically significant (p0. 001). 3. This study shows that the positive rate of HPV infection in all age groups is not exactly the same, the difference is statistically significant (p0.01). 4. The positive rate of HPV in cervical cancer group was significantly higher than that in healthy examination group, cervicitis group and precancerous lesion group (p0. 001), and the positive rate in precancerous lesion group was significantly higher than that in cervicitis group and healthy examination group (p0. 001). In this study, 115 cases of HPV single infection, 34 cases of double infection and 3 cases of multiple infection were detected in 415 subjects. Among them, the most common infection of HPV52 type co-infection was still single subtype infection, and multiple infection accounted for only a small part. The SCC of the cervical cancer group was significantly higher than that of the precancerous lesion group and the normal control group (P0.001), and the SCC of the cervical precancerous lesion group was significantly higher than that of the normal control group (P0.001), and the SCC of the cervical cancer group was significantly higher than that of the normal control group (P0.001). There was no significant difference in AFP between precancerous lesion group and normal control group (P0.05). The level of SCC in cervical cancer group and normal control group was detected by AFPG-CEACA125CA1999.The value of single, double, three, four and five combined tests in the diagnosis of cervical cancer was analyzed. The results showed that five combined tests were the most sensitive in the diagnosis of cervical cancer. Compared with other diagnostic methods, there was significant difference (p0.05). In the diagnosis of cervical cancer, the area under the SCC curve was larger than that of the AFP-CEACA199CA199CA125, and had a higher sensitivity in the diagnosis of cervical cancer by ROC curve analysis of five serum tumor markers. The sensitivity of combined detection of CA125.9.HPV and AFPCEA CA125 CA199C was higher than that of single detection of HPV and single detection of five tumor markers. Conclusion the combined detection of human papillomavirus (HPV) and five tumor markers can be used for early diagnosis of cervical cancer.
【学位授予单位】：天津医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.33
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