分析血清鳞状细胞癌抗原及人附睾蛋白4对早期宫颈癌的临床诊断价值

Diagnostic value of combined detection of serum SCC-Ag and HE4 in early cervical cancer

目的探讨血清鳞状细胞癌抗原(squamous cell carcinoma antigen,SCC-Ag)和人附睾蛋白4(human epididymis protein 4,HE4)联合检测在诊断早期宫颈癌中的临床价值。方法回顾性分析490例早期宫颈癌患者、193例宫颈上皮内瘤变患者及72例健康女性血清SCC-Ag和HE4的表达水平,构建Logistic回归模型,绘制ROC曲线并计算AUC,评价其临床诊断价值。结果观察组血清SCC-Ag及HE4明显高于良性对照组和正常对照组,差异有统计学意义(P<0.01);良性对照组和正常对照组比较,差异无统计学意义(P>0.05)。以健康人群为参照,血清SCC-Ag和HE4联合检测诊断早期宫颈癌的曲线下面积、敏感度、特异度、准确度分别为0.826、73.90%、81.90%、78.83%;以良性患者为参照,血清SCC-Ag和HE4联合检测诊断早期宫颈癌的曲线下面积、敏感度、特异度、准确度分别为0.825,63.70%、91.20%、74.67%,联合检测的诊断效能指标优于各单项检测。结论血清SCC-Ag和HE4联合检测对鉴别早期宫颈癌具有重要价值,值得临床推广。

Objective To investigate the clinical diagnostic value of combined detection of serum squamous cell carcinoma antigen（ SCC- Ag） and human epididymis protein 4（ HE4） in early cervical carcinoma. Methods The expression levels of serum SCC- Ag and HE4 were retrospectively analyzed in 72 healthy individuals,193 patients with cervical intraepithelial neoplasia and 490 patients with early cervical cancer. Logistic regression model was constructed,and the receiver- operating characteristic curve（ ROC） was drawed to evaluate the clinical diagnostic value. Results The levels of serum SCC- Ag and HE4 in the observation group were significantly higher than that in the benign control group and healthy control group,and the differences had statistical significance（ P〈0. 01）,whereas there was no statistical difference between benign control group and healthy control group（ P〈0. 05）. Taking healthy people as reference,the diagnostic AUC of serum SCC- Ag and HE4 for early cervical cancer was 0. 826,the sensitivity,speciality and accuracy of 73. 90%,81. 90% and 78. 83%,respectively. Taking benign group as reference,the diagnostic AUC of serum SCC- Ag and HE4 for early cervical cancer was 0. 825,the sensitivity,speciality and accuracy of 63. 70%,91. 20% and 74. 67%,respectively,and the diagnostic efficacy of combined detection was better than that of single detection. Conclusion Combined detection of serum SCC- Ag and HE4 can improve the diagnostic value for early cervical cancer and it is worthy of clinical promotion.