血清脂联素及内脂素水平与子宫内膜癌关系的临床意义探讨

Investigation into the clinical significance of serum adiponectin and visfatin levels in relation to endometrial cancer

目的：探讨血清脂联素（Adiponectin）、内脂素（Visfatin）水平与子宫内膜癌的关系,及两者联合测定对子宫内膜癌诊断的临床价值。方法：收集2009年5月至2013年1月就诊于大连医科大学附属大连市妇产医院的56例子宫内膜癌患者作为病例组,同期常规体检排除肿瘤病史的98例女性作为对照组。ELISA法测定血清脂联素、内脂素水平。结果：病例组患者的血清脂联素水平显著低于对照组（P〈0.05）;血清内脂素水平高于对照组,但无显著差异（P〉0.05）。病例组的内脂素与脂联素比值显著高于对照组（P〈0.05）。血清脂联素、内脂素水平与子宫内膜癌的手术病理分期、病理类型、组织分级无关（P〉0.05）。血清脂联素水平降低（OR=0.879,95%CI为0.870～0.899,P〈0.05）、内脂素水平升高（OR=1.980,95%CI为1.987～1.018,P〈0.05）是子宫内膜癌发病的独立危险因素。血清脂联素〈2.62μg/ml时,诊断子宫内膜癌的灵敏度为85.7%,特异度为72.6%。结论：子宫内膜癌症患者的血清脂联素水平降低。血清内脂素水平升高、脂联素水平降低是子宫内膜癌发病的独立危险因素;血清脂联素可为宫内膜癌诊断提供参考价值。

Objective： To investigate the relationship between serum adiponectin,visfatin with endometrial cancer,to explore the clinical value of combined detection of serum adiponectin,visfatin in diagnosis of endometrial cancer. Methods： Collected 56 cases of EC in May2009 to Jan. 2013 and 98 females that exclude history of cancer for the routine physical examination in the same period in comparison. The levels of serum adiponectin and visfatin of 98 cases of EC patients and 56 controls was determined by ELISA. Results： In the control group,serum adiponectin levels were significantly higher than the case group（ P〈0. 05）. Serum visfatin levels of the control group lower than the case group,but no significant difference（ P〈0. 05）.Visfatin and adiponectin ratio of case group was significantly higher than that in the control group,the difference was statistically significant（ P〈0. 05）. There was no correlation of the levels of serum adiponectin and visfatin in various FIGO stage,histologic differentiation and histopathologic grade. serum lower adiponectin levels（ OR = 0. 879,95% CI 0. 870 ～ 0. 899,P〈0. 05）,elevated visfatin levels（ OR = 1. 980,95% CI 1. 987 ～ 1. 018,P〈0. 05） was an independent risk factor for endometrial cancer. When the serum adiponectin level greater than2. 62μg /ml demonstrated sensitivity and specificity of 85. 7% and 72. 6%. Conclusions： Serum adiponectin levels in patients with endometrial cancer decreased. Serum decreased adiponectin level and increased visfatin levels are independent risk factor for EC. Serum adiponectin may have some value in the diagnosis of endometrial cancer.