血清S100A11、S100A14、CA125与ⅡB~Ⅳ期上皮性卵巢癌患者减瘤术结局的关系及其预测价值分析

Relationship between serum S100A11,S100A14,CA125 and cytoreductive surgery outcomes in patients with stageⅡB-Ⅳepithelial ovarian cancer and their predictive value

目的 探讨ⅡB~Ⅳ期上皮性卵巢癌(EOC)患者血清S100钙结合蛋白A(S100A)11、S100A14和糖类抗原125(CA125)水平与肿瘤细胞减灭术(简称减瘤术)结局的关系及其预测价值。方法 选取2018年6月至2021年6月于该院接受初始减瘤术的ⅡB~Ⅳ期的124例EOC患者作为EOC组及70例卵巢良性病变患者作为病例对照组,并选取同期于该院体检的体检健康者70例作为健康对照组。检测各组血清S100A11、S100A14、CA125水平。根据EOC患者减瘤术结局是否满意,分为满意组(70例)和不满意组(54例)。分析ⅡB~Ⅳ期EOC患者减瘤术结局不满意的影响因素,并评估血清S100A11、S100A14、CA125预测ⅡB~Ⅳ期EOC患者减瘤术结局不满意的临床价值。结果 EOC组血清S100A11、S100A14、CA125水平高于病例对照组及健康对照组,差异有统计学意义(P<0.05)。不满意组美国麻醉医师协会(ASA)分级Ⅲ级、腹水、国际妇产科联盟(FIGO)分期ⅢC~Ⅳ期比例及血清CA125、S100A11、S100A14水平均高于满意组,差异有统计学意义(P<0.05)。FIGO分期ⅢC~Ⅳ期及血清CA125、S100A11、S100A14水平升高是影响EOC患者减瘤术结局不满意的独立危险因素(P<0.05)。血清CA125、S100A11、S100A14及三者联合预测EOC患者减瘤术结局不满意的曲线下面积(95%CI)分别为0.727(0.521~0.910)、0.747(0.507~0.961)、0.755(0.553~0.954)、0.825(0.743~0.913),三者联合检测预测减瘤术结局不满意的价值优于血清CA125、S100A11、S100A14单独检测。结论 ⅡB~Ⅳ期EOC患者血清S100A11、S100A14、CA125水平升高,与减瘤术结局不满意有关,血清CA125、S100A11、S100A14联合检测对减瘤术结局不满意具有较高的预测价值。

Objective To investigate the relationship between serum S100 calcium binding protein A(S100A)11,S100A14 and carbohydrate antigen 125(CA125)levels and the outcome of initial cytoreductive surgery in patients with stageⅡB-Ⅳepithelial ovarian cancer(EOC)and their predictive value.Methods A total of 124 patients with stageⅡB-ⅣEOC who underwent initial cytoreductive surgery in the hospital from June 2018 to June 2021 were selected as the EOC group,70 patients with benign ovarian lesions were selected as the case control group,and 70 healthy people who underwent physical examination in the hospital during the same period were selected as the healthy control group.Serum levels of S100A11,S100A14 and CA125 were detected in each group.According to the outcome of cytoreductive surgery,EOC patients were divided into satisfactory group(70 cases)and unsatisfactory group(54 cases).The influencing factors of unsatisfactory surgical outcomes in patients with stageⅡB-ⅣEOC were analyzed,and the clinical value of serum S100A11,S100A14 and CA125 in predicting unsatisfactory surgical outcomes in patients with stageⅡB-ⅣEOC was evaluated.Results The serum levels of S100A11,S100A14 and CA125 in EOC group were higher than those in case control group and healthy control group(P<0.05).The proportions of American Society of Anesthesiologists(ASA)gradeⅢ,ascites,International Federation of Gynecology and Obstetrics(FIGO) stage ⅢC-Ⅳ and serum levels of CA125,S100A11 and S100A14 in unsatisfactory group were significantlyhigher than those in satisfactory group (P <0.05).FIGO stage ⅢC-Ⅳ and elevated serum levels of CA125,S100A11 and S100A14 were independent risk factors affecting the unsatisfactory outcome of cytoreductivesurgery in patients with EOC(P <0.05).The area under the curve (95%CI) of serum CA125,S100A11,S100A14 and the combination of the three to predict the unsatisfied outcome of EOC patients were 0.727(0.521-0.910),0.747 (0.507-0.961),0.755 (0.553-0.954) and 0.825 (0.743-0.913),respectively.Thepredictive value of combined detection of CA125,S100A11 and S100A14 in predicting unsatisfactory outcomeof cytoreductive surgery was better than that of serum CA125,S100A11 and S100A14 alone.Conclusion The elevatedserum levels of S100A11,S100A14 and CA125 in patients with stage ⅡB-Ⅳ EOC are associated withthe unsatisfactory outcome of cytoreductive surgery.The combined detection of serum CA125,S100A11 andS100A14 has a high predictive value for the unsatisfactory outcome of cytoreductive surgery.