糖链抗原125及19-9和中性粒细胞/淋巴细胞比值联合检测诊断子宫内膜异位症价值

Combined detection of carbohydrate antigen 125,19-9 and neutrophil-to-lymphocyte ratio in the diagnosis of endometriosis

目的研究糖链抗原(carbohydrate antigen,CA)125、CA19-9、中性粒细胞/淋巴细胞比值(neutrophil-tolymphocytes ratio,NLR)及其联合应用对子宫内膜异位症(endometriosis,EM)的诊断价值。方法拟诊EM并行腹腔镜检查患者251例,根据CA125、CA19-9和NLR等指标,采用ROC和logistic回归方程分析3项指标及其联合检测对EM的诊断价值;分析3项指标相关性及其与患者临床特征间的关系。结果以腹腔镜检查结果为标准,158例EM患者为EM组,93例非EM患者为非EM组,EM组CA125[(64.00±39.00)u/mL]、CA19-9[(27.00±14.00)u/mL]、NLR(2.91±1.28)高于非EM组[(37.00±26.00)u/mL、(20.00±13.00)u/mL、2.18±1.14](P<0.05);CA125与NLR、CA19-9无明显相关性(r=0.110,P=0.170;r=0.120,P=0.160),CA19-9与NLR呈正相关(r=0.170,P=0.040);CA125、CA19-9和NLR诊断EM的AUC分别为0.73、0.68和0.70,3项联合诊断的AUC(0.78)高于单项指标的AUC;CA125、CA19-9和NLR均随EM分期的递进而增加(P<0.01)。结论 CA125、CA19-9和NLR联合诊断可提高EM诊断的准确性。

Objective To investigate the value of combined detection of carbohydrate antigen （CA） 125, CA19-9 and neutrophil-to-lymphocyte ratio （NLR） to the diagnosis of endometriosis （EM）. Methods ROC curve and logistic regression model were used to evaluate the values of the combined and single detection of CA125, CA19-9 and NLR to the diagnosis of EM in 251 suspected EM patients. The correlations among these markers and their relationship with the clinical characteristics were analyzed. Results Taking the laparoscopic results as the standard, 251 patients were divided into EM group （n=158） and no-EM group （n=93）. The values of CA125 （（64.00±39.00） u/mL）, CA19-9 （（27.00±14.00） u/mL） and NLR （2.91±1. 28） were significantly higher in EM group than those in no-EM group （（37. 00± 26.00） u/mL, （20.00±13.00） u/mL, （2. 18±1. 14）） （P〈0.05）. CA125 had no obvious correlation with NLR and CA19-9 （r=0.110, P=0.170; r=0.120, P=0.160）. CA19-9 was positively correlated withNLR （r=0.170, P= 0. 040）. The AUC values of CA125, CA19-9 and NLR for EM were 0.73, 0.68 and 0.70, respectively. The AUC value of combined detection for EM was 0.78, significantly higher than that of any signal marker. CA125, CA19-9 and NLR were significantly increased as the progress of EM staging. Conclusion Combined detection of CA125, CA19-9 and NLR can improve the diagnostic accuracy of endometriosis.