血清HE4、TK1、CA125检测对子宫内膜异囊肿、卵巢癌的诊断价值及意义

发布时间：2018-05-02 03:44

本文选题：人附睾分泌蛋白4 + 细胞质胸苷激酶1　；参考：《安徽医科大学》2017年硕士论文

【摘要】：目的本研究通过测定HE4、TK1、CA125在子宫内膜异位囊肿、卵巢癌患者和健康对照组外周血的表达情况,评价血清HE4、TK1、CA125及HE4、CA125二者联合在子宫内膜异位囊肿和卵巢癌诊断中的价值。方法随机选取2014年1月到2015年3月安徽医科大学第一附属医院诊治的子宫内膜异位囊肿的患者,经临床病理确诊的患者71例为子宫内膜异位囊肿组;经手术后病理确诊为卵巢癌的患者65例为卵巢癌组。随机选取在本院健康体检正常的女性70例为健康对照组。三组在年龄上无统计学差异。分别测定三组的血清HE4、TK1和CA125水平,比较三组之间三肿瘤指标有无统计学差异。将三组肿瘤指标绘制成检测卵巢癌的ROC曲线,比较其曲线下面积,根据约登指数(灵敏度+特异度-1),从而比较三组在灵敏度和特异度的差别。约登指数最大时三组肿瘤指标的水平为判断卵巢癌的最佳临界值。结果1.内异症组HE4、TK1水平均略高于健康对照组,但两组比较差异无统计学意义(P0.05);卵巢癌组血清HE4、TK1水平及其阳性率亦高于对照组,与健康对照组比较差异有统计学意义(P均0.05);内异症组血清CA125水平及其阳性率均高于对照组,与健康对照组比较差异有统计学意义(P均0.05),卵巢癌组血清CA125水平及其阳性率均高于对照组,差异均有统计学意义(P均0.05)。HE4联合CA125诊断子宫内膜异位囊肿的敏感度和特异度均显著高于HE4或CA125单独诊断(P均0.05),得出血清HE4联合CA125检测能明显提高盆腔子宫内膜异位症(EMT)诊断的灵敏度、特异度及符合率。2.血清HE4、CA125、TK1水平对内异症患者的诊断灵敏度、特异度、符合率分别为:72.31%(47/65)、71.83%(51/71)、72.06%(98/136);73.85%(48/65)、76.06%(54/71)、75.00%(102/136);70.77%(46/65)、63.38%(45/71)、66.91%(91/136)。血清HE4联合血清CA125对内异症患者的诊断的灵敏度、特异度、符合率分别为90.77%(59/65)、88.73%(63/71)、89.71%(122/136)。均高于HE4、CA125单独诊断,且差异有统计学意义(P0.05)。血清HE4、CA125、TK1水平对卵巢癌患者诊断的灵敏度、特异度、符合率分别为89.23%(58/65)、87.32%(62/71)、88.24%(120/136);69.23%(45/65)、74.65%(53/71)、72.06%(98/136);76.92%(50/65)、66.20%(47/71)、71.32%(97/136)。血清HE4联合血清CA125对卵巢癌患者的诊断灵敏度、特异度、符合率分别为92.31%、90.14%(64/71)、91.18%(124/136)。均高于HE4、CA125单独诊断,且差异有统计学意义(P0.05)。3.卵巢癌最佳临界值的选择为(灵敏度+特异度-1)这个值最大的患者体内血清测得的HE4、CA125和TK1水平。血清HE4、CA125、TK1对卵巢癌诊断,当HE4诊断分界点取值68.35 pmol/L时,诊断敏感性为89.23%,特异性为87.32%;当CA125诊断分界点取值264.54U/ml时,诊断敏感性为69.23%,特异性为74.65%;当TK1诊断分界点取值0.95pmol/L时,诊断敏感性为76.92%,特异性为66.20%;HE4的诊断价值均好于CA125、TK1。结论1.血清HE4联合CA125检测能明显提高盆腔子宫内膜异位症(EMT)诊断率。2.血清TK1在子宫内膜异位症患者的诊断中无明显的临床意义。3.血清HE4对卵巢癌有诊断价值。
[Abstract]:Objective to evaluate the value of HE4, TK1, CA125 in endometriosis cysts, ovarian cancer patients and healthy controls, and to evaluate the value of serum HE4, TK1, CA125 and HE4, CA125 two in the diagnosis of endometriosis cysts and ovarian cancer. Methods randomly selected the Medical University Of Anhui from January 2014 to March 2015. In a Affiliated Hospital, 71 patients with endometriosis cyst diagnosed by clinicopathological diagnosis were endometriosis cysts, and 65 cases of ovarian cancer were diagnosed as ovarian cancer after surgery. 70 cases of normal healthy women in our hospital were randomly selected as the healthy control group. The three groups were not statistically different in age. The levels of serum HE4, TK1 and CA125 in the three groups were measured, and there were no statistical differences between the three groups. The three groups of tumor indexes were plotted to detect the ROC curve of ovarian cancer, and the area under the curve was compared, and the difference between the sensitivity and specificity of the three groups was compared. The maximum index of the three groups was the largest. The level of the three groups of tumor markers was the best critical value for judging ovarian cancer. Results the level of HE4 and TK1 in the group of 1. endometriosis was slightly higher than that in the healthy control group, but there was no significant difference between the two groups (P0.05), and the serum HE4, TK1 level and the positive rate of the ovarian cancer group were also higher than those in the control group, and the difference was statistically significant (P 0.05) compared with the healthy control group. The level of serum CA125 and its positive rate in the group of endometriosis were higher than those in the control group (P 0.05). The serum CA125 level and the positive rate of the ovarian cancer group were higher than those in the control group. The difference was statistically significant (P all 0.05) the sensitivity and specificity of.HE4 combined CA125 diagnosis of endometriosis cysts were both significant The diagnostic sensitivity, specificity and coincidence rate of.2. serum HE4, CA125 and TK1 in the diagnosis of endometriosis (EMT) in pelvic endometrium (EMT) was significantly higher than that of HE4 or CA125 (P 0.05). The specificity and specificity of.2. serum HE4, CA125 and TK1 were 72.31% (47/65), 71.83% (51/71) and 72.06%, respectively. 73.85% (48/65), 76.06% (54/71), 75% (102/136); 70.77% (46/65), 63.38% (45/71), 66.91% (91/136). The sensitivity and specificity of serum HE4 combined with serum CA125 for the diagnosis of endometriosis were 90.77% (59/65), 88.73% (63/71), 89.71% (122/136) respectively. 4, CA125, TK1 levels were sensitive and specific for the diagnosis of ovarian cancer, and the specificity was 89.23% (58/65), 87.32% (62/71), 88.24% (120/136); 69.23% (45/65), 74.65% (53/71), 72.06% (98/136); 76.92% (50/65), 66.20% (47/71), 71.32% (97/136). Serum HE4 combined serum diagnostic sensitivity, specificity and coincidence rate for ovarian cancer patients. Do not be 92.31%, 90.14% (64/71), 91.18% (124/136). All were higher than HE4 and CA125 alone, and the difference was statistically significant (P0.05) the best critical value of.3. ovarian cancer was the HE4, CA125 and TK1 levels measured in the serum of the patients with the maximum value of (sensitivity + specificity -1). When the value of 68.35 pmol/L, the diagnostic sensitivity was 89.23%, the specificity was 87.32%, when the CA125 diagnosis demarcation point value 264.54U/ml, the diagnostic sensitivity was 69.23%, the specificity was 74.65%. When the TK1 diagnosis demarcation point value 0.95pmol/L, the diagnostic sensitivity was 76.92%, the specificity was 66.20%; the value of HE4 was better than CA125, TK1. conclusion 1. serum HE4 combined CA12. 5 detection can obviously improve the diagnostic rate of pelvic endometriosis (EMT).2. serum TK1 has no significant clinical significance in the diagnosis of endometriosis patients.3. serum HE4 has a diagnostic value for ovarian cancer.

【学位授予单位】：安徽医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.31;R711.74

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