子宫内膜癌患者BMI与血清HE4,CA125联合检测的诊断价值

Diagnostic Value of Combined Detection of Body Mass Index and Serum HE4,CA125 in Patients with Endometrial Carcinoma

目的评价身体质量指数(body mass index,BMI)与人睾分泌蛋白(human epididymis protein4,HE4)、糖类抗原125(carbohydrate antigen,CA125)联合检测在子宫内膜癌诊断中的价值。方法选择2016年3月～2017年6月住院拟行手术治疗子宫内膜癌患者81例,子宫内膜良性病变患者70例;采集所有研究对象的身高、体重资料,计算BMI;采用电化学发光法检测血清HE4和CA125含量水平,并对结果进行分析。结果子宫内膜癌组患者血清HE4(Z=-17.613),CA125(Z=-5.327)含量水平,以及BMI(t=2.264)较子宫内膜良性病变组明显升高,差异有统计学意义(均P<0.05);子宫内膜癌组肥胖率(49.4%)高于内膜良性病变组(30.0%)(χ~2=5.859,P=0.015);在BMI<28.0kg/m^2和BMI≥28.0kg/m^2水平子宫内膜癌组HE4含量均高于内膜良性病变组(Z=-8.026,-12.154,均P<0.05),而CA125仅在BMI<28.0kg/m^2时子宫内膜癌组高于内膜良性病变组(Z=-7.178,P<0.05);ROC曲线分析显示,HE4,CA125和BMI单独检测的曲线下面积分别为0.795,0.692和0.648;而三项联合检测的曲线下面积最大,为0.841。三项联合检测的敏感度和特异度分别为0.75,0.79,Youden指数为0.54;均优于各指标单项检测时的诊断效能。结论 BMI与血清HE4,CA125联合诊断子宫内膜癌效能优于单项检测。

Objective To evaluate the value of combination detection of BMI and HE4, CA125 in the diagnosis of endometrial carcinoma. Methods 81 patients with endometrial cancer and 70 patients with endometrial benign lesion were enrolled in this study. The height and weight of all the patients were collected, then the BMI of all the patients were accounted. The levels of CA125 and HE4 were detected by electrochemiluminescence,and the results were analyzed. Results The level of HE4（Z= —17. 613）,CA125（Z= 5. 327） and BMI（t=2. 264） in the patients with endometrial cancer group were significantly increased comparing to endometrium benign lesion group （all P^0.05）. The obesity rate of endometrial carcinoma group （49.4~） was significantly higher than that of endometrial benign lesion group （~ = 5. 859, P〈0. 015）. Further subgroup analysis according to BMI （BMI 〈28.0 kg/me versus BMI≥28.0 kg/me） revealed significant differences between endome- trial cancer group and endometrial benign lesion group for HE4 levels （Z= 8. 026, 12. 154,all P^0.05）,while serum CA-125 levels were significantly different only in BMI≥28.0 kg/me （Z= 7. 178, P^0.05）. ROC curve analysis showed that the AUC of HE4, CA125 and BMI was 0. 795,0. 692 and 0. 648 respectively, while the AUC of combination detection of HE4,CA125 and BMI was the largest, which was 0. 841. The sensitivity and specificity of combination detection were 0.75 and 0.79, and the Youden index was 0.54, which was better than the diagnostic efficiency of the single item test. Conclusion The combination detection of BMI and HE4, CA125 in diagnosis of endometrial carcinoma is superior to single detection.