血清HE4、LH、FSH对宫颈癌和宫颈上皮内瘤变的鉴别诊断价值

Differential Diagnosis Value of Serum HE4,LH and FSH on Cervical Cancer and Cervical Intraepithelial Neoplasia

目的探究血清人附睾蛋白4(HE4)、促黄体生成素(LH)、卵泡刺激素(FSH)对宫颈癌和宫颈上皮内瘤变(CIN)的鉴别诊断价值。方法选择89例接受宫颈癌筛查的宫颈病变患者,经病理学或细胞学明确诊断宫颈癌51例、CIN 38例,检测所有患者血清HE4、LH、FSH水平,分析宫颈癌患者与CIN患者血清检测指标水平差异,采用受试者特征工作曲线(ROC曲线)、二元logistics回归分析法评价HE4、LH、FSH在疾病鉴别中的价值。结果宫颈癌患者血清HE4、LH、FSH水平均显著高于CIN患者(P<0.05);宫颈病变患者血清HE4与LH、FSH水平呈正相关(γ=0.357、0.392,P<0.05)。ROC曲线分析显示,血清HE4、LH、FSH诊断宫颈癌的敏感性均较低,三者联合诊断效能较单一指标更高,联合诊断曲线下面积为0.859,诊断敏感度88.24%、特异度71.05%;logistics回归分析显示,HE4>62.84 pmol/ml是宫颈癌发病的影响因素(P<0.05)。结论宫颈癌患者血清HE4、LH、FSH水平异常升高,且指标间呈正相关,三者联合用于鉴别诊断宫颈癌和CIN具有一定临床价值。

Objective To explore the differential diagnosis value of serum human epididymis protein 4(HE4),luteinizing hormone(LH)and follicle stimulating hormone(FSH)on cervical cancer and cervical intraepithelial neoplasia(CIN).Methods 89 patients with cervical lesions who received cervical cancer screening were selected.51 cases of cervical cancer and 38 cases of CIN were diagnosed by pathology or cytology.Serum HE4,LH and FSH levels were detected among all patients,and the differences in serum detection indicators were analyzed in patients with cervical cancer and patients with CIN.Receiver characteristic operating curve(ROC curve)and binary logistics regression analysis were used to evaluate the value of HE4,LH and FSH on disease identification.Results Serum levels of HE4,LH and FSH in patients with cervical cancer were significantly higher than those in patients with CIN(P<0.05).Serum HE4 was positively correlated with LH and FSH levels in patients with cervical lesions(γ=0.357、0.392,P<0.05).ROC curve analysis showed that the sensitivities of serum HE4,LH and FSH in the diagnosis of cervical cancer were low,and the diagnostic efficiency of the combination of the three indicators was higher than that of single indicator,and the area under the curve,sensitivity and specificity of combined diagnosis were 0.859,88.24%and 71.05%.Logistics regression analysis showed that HE4>62.84 pmol/ml was an influencing factor of incidence of cervical cancer(P<0.05).Conclusion Serum levels of HE4,LH and FSH in patients with cervical cancer are abnormally elevated,and there is a positive correlation among the indicators.The combined application of the three indicators has certain clinical value in the differential diagnosis of cervical cancer and CIN.