子宫腺肌病患者血清与组织中HE4的表达水平及临床意义
发布时间：2018-12-09 20:33
【摘要】：目的 通过检测子宫腺肌病患者血清HE4、CA125的含量及组织中HE4的表达，探讨HE4与子宫腺肌病的相关性。 方法 采用ELISA法检测济南军区总医院妇科收住院的40例子宫腺肌病患者（术后病理证实为子宫腺肌病，排除合并子宫内膜异位症、子宫肌瘤及其他恶性肿瘤）术前血清HE4、CA125的含量，随机选取28例门诊健康体检妇女作为对照；采用SP法检测相对应的40例子宫腺肌病组织中HE4的表达，24例正常子宫内膜组织作为对照。 结果 1.子宫腺肌病患者血清HE4、CA125的含量分别为39.67±13.56pmol/L和150.57±124.51U/ml，均显著高于健康对照组20.08±5.94pmol/L和10.75±7.10U/ml，差异有统计学意义（t＝7.166，P＝0.000；t＝5.922，P＝0.000）；且二者的表达水平呈线性相关（r＝0.411，P＝0.008）。 2.子宫腺肌病组以健康组为参照，ROC曲线下面积为0.909，标准误为0.037，95%置信区间（0.840，，0.978），当血清HE4的最佳诊断界值点（cut off值）为31.035pmol/L时，灵敏度为0.825，特异度为0.964，诊断指数最高为0.789，此时诊断价值较高。 3.HE4在腺肌病异位病灶组织中多为强阳性表达，阳性表达率为72.50%，显著高于在位内膜组（47.50%）和正常子宫内膜组（45.83%），差异有统计学意义（x2＝5.208，P＝0.022；x2＝4.551，P＝0.033）；但HE4在在位内膜组与正常子宫内膜组比较无差异（x2＝0.017，P＝0.897）。 4.弥漫型腺肌病组血清及组织中HE4的表达显著高于局限型组，差异有统计学意义（P=0.042），在腺肌病不同月经周期及不同子宫大小分组中的表达无差异（P=1.000，P=0.147），且血清与组织中HE4的表达水平呈线性相关（r＝0.386，P＝0.014）。 结论 1.子宫腺肌病患者血清与组织中HE4的表达明显升高，且二者的表达呈线性相关，尤其是在弥散型腺肌病组中的表达最高，提示HE4可能增强了异位内膜细胞向肌层的侵袭、浸润能力，可能促进子宫腺肌病的发生和发展。 2.子宫腺肌病患者血清HE4的含量最高为83.07pmol/L；ROC曲线下面积为0.909，以31.035pmol/L作为诊断临界值时，特异度为96.4%，灵敏度为82.5%，提示HE4对子宫腺肌病的诊断及鉴别诊断具有一定作用。
[Abstract]:Objective to investigate the correlation between HE4 and adenomyosis by detecting the content of serum HE4,CA125 and the expression of HE4 in the tissues of patients with adenomyosis. Methods ELISA method was used to detect serum HE4, before operation in 40 patients with adenomyosis (confirmed by pathology after operation, excluding endometriosis, uterine leiomyoma and other malignant tumors) in gynecological department of Jinan military region General Hospital. CA125 content, 28 healthy women were randomly selected as control group. SP method was used to detect the expression of HE4 in 40 cases of adenomyosis and 24 cases of normal endometrium as control. Result 1. The serum HE4,CA125 levels in patients with adenomyosis were 39.67 卤13.56pmol/L and 150.57 卤124.51 U / ml, respectively, which were significantly higher than those in the healthy control group (20.08 卤5.94pmol/L and 10.75 卤7.10 U / ml). P0. 000; There was a linear correlation between the two expression levels (r = 0.411P ~ (0.000), and a linear correlation was found between the two expression levels (r ~ (0.411) P ~ (+) ~ (0.008). 2. In the adenomyosis group, the area under the ROC curve was 0.909, and the standard error was 0.037% confidence interval (0.840 卤0.978). When the best diagnostic threshold for serum HE4 was 31.035pmol/L, the area under the ROC curve was 0.909, and the standard error was 0.037% confidence interval (0.840 卤0.978). The sensitivity was 0.825, the specificity was 0.964, the highest diagnostic index was 0.789, and the diagnostic value was higher. The positive expression rate of 3.HE4 in ectopic lesions of adenomyosis was 72.50%, which was significantly higher than that in eutopic endometrium (47.50%) and normal endometrium (45.83%). The difference was statistically significant (x2 + 5.208). There was no significant difference in HE4 between eutopic endometrium group and normal endometrium group (x 2 0. 017 P < 0. 097), but there was no significant difference in HE4 between eutopic endometrium group and normal endometrium group (x 2 0. 017 P < 0. 097). 4. The expression of HE4 in serum and tissues of diffuse adenomyosis group was significantly higher than that in localized type group (P0. 042). There was no difference in the expression of HE4 in different menstrual cycle and different uterine size groups of adenomyosis (P0. 000 P0. 147). There was a linear correlation between the expression of HE4 in serum and tissue (r = 0.386 P0. 014). Conclusion 1. The expression of HE4 in serum and tissue was significantly increased in patients with adenomyosis, and the expression of HE4 was linearly correlated, especially in the diffuse adenomyosis group, suggesting that HE4 might enhance the invasion of ectopic endometrial cells to the myometrium. Infiltration ability may promote the occurrence and development of adenomyosis. 2. The highest level of serum HE4 was 83.07 pmol / L in patients with adenomyosis. The area under the ROC curve was 0.909. When 31.035pmol/L was used as the diagnostic critical value, the specificity was 96.4 and the sensitivity was 82.5, which suggested that HE4 had a certain role in the diagnosis and differential diagnosis of adenomyosis.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.71
本文编号：2369987
[Abstract]:Objective to investigate the correlation between HE4 and adenomyosis by detecting the content of serum HE4,CA125 and the expression of HE4 in the tissues of patients with adenomyosis. Methods ELISA method was used to detect serum HE4, before operation in 40 patients with adenomyosis (confirmed by pathology after operation, excluding endometriosis, uterine leiomyoma and other malignant tumors) in gynecological department of Jinan military region General Hospital. CA125 content, 28 healthy women were randomly selected as control group. SP method was used to detect the expression of HE4 in 40 cases of adenomyosis and 24 cases of normal endometrium as control. Result 1. The serum HE4,CA125 levels in patients with adenomyosis were 39.67 卤13.56pmol/L and 150.57 卤124.51 U / ml, respectively, which were significantly higher than those in the healthy control group (20.08 卤5.94pmol/L and 10.75 卤7.10 U / ml). P0. 000; There was a linear correlation between the two expression levels (r = 0.411P ~ (0.000), and a linear correlation was found between the two expression levels (r ~ (0.411) P ~ (+) ~ (0.008). 2. In the adenomyosis group, the area under the ROC curve was 0.909, and the standard error was 0.037% confidence interval (0.840 卤0.978). When the best diagnostic threshold for serum HE4 was 31.035pmol/L, the area under the ROC curve was 0.909, and the standard error was 0.037% confidence interval (0.840 卤0.978). The sensitivity was 0.825, the specificity was 0.964, the highest diagnostic index was 0.789, and the diagnostic value was higher. The positive expression rate of 3.HE4 in ectopic lesions of adenomyosis was 72.50%, which was significantly higher than that in eutopic endometrium (47.50%) and normal endometrium (45.83%). The difference was statistically significant (x2 + 5.208). There was no significant difference in HE4 between eutopic endometrium group and normal endometrium group (x 2 0. 017 P < 0. 097), but there was no significant difference in HE4 between eutopic endometrium group and normal endometrium group (x 2 0. 017 P < 0. 097). 4. The expression of HE4 in serum and tissues of diffuse adenomyosis group was significantly higher than that in localized type group (P0. 042). There was no difference in the expression of HE4 in different menstrual cycle and different uterine size groups of adenomyosis (P0. 000 P0. 147). There was a linear correlation between the expression of HE4 in serum and tissue (r = 0.386 P0. 014). Conclusion 1. The expression of HE4 in serum and tissue was significantly increased in patients with adenomyosis, and the expression of HE4 was linearly correlated, especially in the diffuse adenomyosis group, suggesting that HE4 might enhance the invasion of ectopic endometrial cells to the myometrium. Infiltration ability may promote the occurrence and development of adenomyosis. 2. The highest level of serum HE4 was 83.07 pmol / L in patients with adenomyosis. The area under the ROC curve was 0.909. When 31.035pmol/L was used as the diagnostic critical value, the specificity was 96.4 and the sensitivity was 82.5, which suggested that HE4 had a certain role in the diagnosis and differential diagnosis of adenomyosis.
【学位授予单位】：泰山医学院
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R711.71
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