胰岛素样生长因子结合蛋白7、INS及乙二醛酶Ⅰ对子宫内膜癌发病风险的预测价值

Serum Expression Levels of IGFBP-7,INS and GLO-Ⅰ in the Patients with Endometrial Tumors

目的探讨胰岛素样生长因子结合蛋白7(IGFBP-7)、胰岛素(INS)及乙二醛酶Ⅰ(GLO-Ⅰ)在子宫内膜病变患者血清中的表达水平及预测子宫内膜癌(EC)的诊断能力。方法选择2013年1月~2015年11月于笔者医院及南通大学附属医院妇科就诊的子宫内膜病变患者210例和正常对照60例共270例,所有研究对象按病理结果分为EC组、子宫内膜不典型增生组、子宫内膜息肉组和正常对照组各80、65、65、60例。4组间比较采用单因素方差分析,其中两组间比较采用q检验;同时对IGFBP-7、INS及GLO-Ⅰ运用ROC曲线分析其对EC的诊断能力。结果 IGFBP-7、INS及GLO-Ⅰ在EC组患者的血清浓度均高于子宫内膜不典型增生组,子宫内膜不典型增生组中3项血清指标浓度均高于子宫内膜息肉组,差异均有统计学意义(P<0.05)。IGFBP-7、INS及GLO-Ⅰ鉴别EC组与子宫内膜不典型增生组的ROC曲线AUC分别为0.677、0.758、0.718,鉴别EC组与子宫内膜息肉组的ROC曲线AUC分别为0.791、0.867、0.820。结论 IGFBP-7、INS及GLO-Ⅰ可作为鉴别子宫内膜良恶性病变的参考指标。

Objective To observe the serum expression levels and the abilities of diagnosis of IGFBP - 7, INS and GLO - I in the patients of Endometrial Tumors. Methods All of the 210 patients with endometrial tumors in our hospital and Nantong University affilia- ted hospital from January 2013 to November 2015 and the 60 cases of heahhy people were divided into endometrial malignant tumor group, endometrial benign tumor group, atypical endometrial hyperplasia group and healthy group. Measurement data were expressed by x ＋ s. The comparison of four samples were analyzed by one - way ANOVA and the comparison of two samples were analyzed by q test. The serum expression levels of IGFBP- 7, INS and GLO - I were evaluated by ROC analysis to evaluate these indexes＇ abilities of diagnosis. Results In the comparison of four groups of samples, the concentration of serum IGFBP - 7, INS and GLO - I in the endometrial ma- lignant tumor group were higher than the atypical endometrial hyperplasia group, the concentration of serum IGFBP - 7, INS and GLO - I in the atypical endometrial hyperplasia group were higher than the endometrial benign tumor group. The difference was statistically sig- nificant（P 〈 0.05）. The ROC analysis of the endometrial malignant tumor group and the atypical endometrial hyperplasia group showed that the AUC of IGFBP - 7, INS and GLO - I were 0. 677,0. 758,0. 718. The ROC analysis of the endometrial malignant tumor group and the endometrial benign tumor group showed that the AUC of IGFBP- 7, INS and GLO - I were 0. 791,0. 867,0. 820 respectively. Conclusion IGFBP - 7, INS and GLO - I can be used for the identification of endometrial benign and malignant tumor.