血清游离DNA检测在卵巢癌的诊断价值

Diagnostic value of cell free DNA detection in ovarian cancer

目的探讨检测血清游离DNA(cf-DNA)在卵巢癌的诊断价值。方法采用分支DNA(bDNA)技术检测36例卵巢癌患者(A组)、22例卵巢良性肿瘤患者(B组)和29例健康妇女(C组)血清cf-DNA含量,用化学发光法检测A组血清中糖链抗原125(CA125)和人附睾蛋白4(HE-4)含量,绘制受试者工作特征(ROC)曲线,评价上述三项指标的诊断效能。结果 A组cf-DNA含量高于B、C组(P<0.01),B、C组cf-DNA含量相仿(P>0.05)。cf-DNA与CA125、HE-4均无明显相关性(r=0.06、0.04,P>0.05)。A组血清cf-DNA的ROC曲线下面积为0.92,高于CA125的0.72和HE-4的0.74。A组诊断卵巢癌的敏感度和特异度分别为88.9%和89.5%,高于CA125的75.0%和52.6%以及HE-4的80.6%和68.4%(P<0.01)。cf-DNA、CA125和HE-4联合检测的敏感度和特异度分别为91.67%和86.21%。结论卵巢癌患者血清cf-DNA诊断卵巢癌敏感度和特异度较高,有一定辅助诊断价值。

Objective To explore the diagnostic value of cell free DNA（cf-DNA） detection in ovarian cancer. Methods Serum concentrations of cf-DNA were detected by branched DNA（bDNA） technology in 36 patients with ovarian cancer（group A）,22 patients with benign ovarian tumor（group B） and 29 healthy women（group C）. The concentrations of cancer antigen 125 （CA125） and human epididymal protein 4 （HE-4） in group A were detected by chemiluminescence method. Receiveroperating characteristic （ROC） curve was drawn to evaluate the diagnostic value of above three indicators. Results Serum level of cf-DNA in group A was higher than that in groups of B and C （P〈0. 01）,which in groups of B and C was similar （P）0. 05）. Serum level of cf-DNA was not significantly correlated to that of CA125 and HE-4 （r= 0.06, r= 0. 04, P〉0. 05）. The area under ROC curve in group A was 0. 92 for d-DNA, which was greater than 0. 7 for CA125 and 0.74 for HE-4 （P〈0.01）. The sensitivity and specificity of cf-DNA in the diagnosis of ovarian cancer were 88.9 % and 89.5% ,which were higher than 75.0% and 52.6% for CA125 and 80. 6% and 68.4% for HE-4 （P〈0. 01）. When combined detection of cLDNA, CA125 and HE-4, the sensitivity and specificity in the diagnosis of ovarian cancer were 91.67 % and 86.21%, respectively. Conclusion Serum level of cf-DNA has high sensitivity and specificity in the diagnosis of ovarian cancer and may he taken as an auxiliary molecular biological indicator.