血清粒细胞集落刺激因子与鳞状细胞癌相关抗原辅助诊断宫颈鳞状细胞癌的意义

Clinical Significance of Granulocyte Serum Colony Stimulating Factor and Squamous Cell Carcinoma Antigen in the Diagnosis,Treatment and Prognosis of Cervical Cancer

目的通过分析血清中粒细胞集落刺激因子(G-CSF)和鳞状细胞癌相关抗原(SCC)的表达水平,探索G-CSF、SCC对辅助诊断宫颈癌的意义。方法收集2011年4月至2016年2月在成都市第七人民医院行G-CSF、SCC、癌胚抗原(CEA)、甲胎蛋白(AFP)检测的临床资料共1 250例。其中,经病理确诊的宫颈鳞癌患者358例(宫颈癌组),宫颈良性病变患者425例(宫颈良性病变组),健康体检者467例(健康对照组)。收集其G-CSF、SCC、CEA和AFP检测值。采用方差分析组间各检测值差异,回归分析检测值在恶性肿瘤中的表达意义,SROC曲线分析SCC和G-CSF在诊断宫颈癌中的意义。结果方差分析结果显示:宫颈癌组各检测值水平、检测值升高百分率均高于宫颈良性病变组和健康对照组,差异有统计学意义(P<0.05);G-CSF诊断宫颈癌SROC曲线下面积AUC=0.994,具有较高诊断准确性;SCC诊断宫颈癌SROC曲线下面积AUC=0.745,具有一定诊断准确性。STATA软件回归分析结果显示:G-CSF、SCC水平在良恶性肿瘤患者中比较,差异有统计学意义(P<0.05),其余指标比较,差异无统计学意义(P>0.05)。结论宫颈癌患者G-CSF、SCC水平高于宫颈良性病变患者或健康人群,G-CSF、SCC可作为宫颈癌的辅助诊断指标。

Objective To explore the clinical significance of serum granulocyte colony stimulating factor （G-CSF） and squamous cell carcinoma antigen （SCC-Ag） in the diagnosis, treatment and prognosis of cervical cancer. Methods The clinical data of the serum G-CSF, SCC-Ag, carcinoembryonic antigen （CEA）, and alphafetoprotein （AFP） were collected from 1250 cases who were tested between April of 2011 and February of 2016 in Chengdu Seventh People＇s Hospital. Among those cases, 358 cases were diagnosed with cervical cancer, 425 cases were with cervical benign neoplasm, and 467 cases were healthy. The statistical variance analysis was used to analyze the differences in the data of the serum G-CSF, SCC-Ag, CEA and AFP, the regression analysis was adopted to explore the expression significance of the detection values in the malignant tumor, and the SR（）C curve analysis was used to evaluate the accuracy of SCC and G-CSF in the diagnosis of cervical cancer. Results The results of the statistical variance analysis showed that the levels of detection values and the percentage rises of those values in patients with cervical cancer were significantly higher than those in patients with cervical benign neoplasm and the healthy cases （P〈0.05）. The area under the curve （AUC） in the G CSF diagnosis was 0. 994 with high accuracy of diagnosing cervical cancer, and the AUC in the SCC diagnosis was 0. 745 with moderate accuracy. The results of the regression analysis showed that the levels of G-CSF and SCC were significantly correlated with both benign and malignant cervical cancer and the other tumor markers were not significantly correlated with cervical cancer. Conclusion The levels of G-CSF and SCC in patients with cervical cancer are higher than those in patients with cervical benign neoplasm and healthy women, so they can be applied as auxiliary diagnosis indexes in the diagnosis, follow-up evaluation, treatment and prognosis of cervical cancer.