宫腔镜联合Ki67、Cyr61检测在子宫内膜癌诊断中的价值

Value of hysteroscopy combined with Ki67 and Cyr61 detection in diagnosis of endometrial carcinoma

目的探讨宫腔镜联合细胞核增殖抗原Ki67 (Ki67)、高半胱氨酸蛋白61 (Cyr61)在子宫内膜癌诊断中的价值,为早期子宫内膜癌的诊断准确性提供依据.方法收集2015年5月-2018年5月疑存在子宫内膜癌患者56作为研究对象,所有受试者均进行宫腔镜以及Ki67、Cyr61检测,以手术病理检测结果为金标准,比较宫腔镜、Ki67、Cyr61各检测结果的总符合率,应用ROC曲线分析Ki67、Cyr61诊断价值,并对比患者宫腔镜、Ki67、Cyr61单项检测以及三项联合检测的诊断效能.结果病理学检测结果显示56例患者中子宫内膜癌42例,非子宫内膜癌14例.经宫腔镜检测56例患者中子宫内膜癌27例,非子宫内膜癌29例,总诊断符合率为60.71%.ROC曲线分析显示Ki67诊断子宫内膜癌的ROC曲线AUC为0.764,截断值为0.16,灵敏度为64.29%,特异度为57.14%;ROC曲线分析显示Cyr61诊断子宫内膜癌ROC曲线AUC为0.760,截断值为2.97,灵敏度为66.67%,特异度为42.86%.联合检测在子宫内膜癌中的准确度、灵敏度分别为91.07%、90.48%显著高于单项检测,差异有统计学意义(P<0.05).结论在子宫内膜癌诊断中宫腔镜为安全有效诊断方式,联合Ki67、Cyr61诊断其诊断价值更高,为临床诊断与治疗提供一定参考.

Objective To explore the value of hysteroscopy combined with nuclear proliferative antigen Ki67(Ki67) and homocysteine 61(Cyr61) in diagnosis of endometrial carcinoma,provide a basis for improving diagnostic accuracy of early endometrial carcinoma. Methods Fifty-six patients suspected of endometrial carcinoma were collected as study object from May 2015 to May 2018,hysteroscopy combined with Ki67 and Cyr61 detection were performed,taking the results of surgery and pathological examination as gold standard,the total coincidence rates of hysteroscopy,Ki67 and Cyr61 detection. ROC was used to analyze the diagnostic value of Ki67 and Cyr61. The diagnostic efficiencies of single detections of hysteroscopy,Ki67,Cyr61 and combined detection were compared. Results Pathological examination showed that there were 42 patients with endometrial carcinoma and 14 patients without endometrial carcinoma. Hysteroscopy showed that there were 27 atients with endometrial carcinoma and 29 patients without endometrial carcinoma. The total diagnostic coincidence rate was 60. 71%. ROC showed that the area under the curve(AUC),cut-off value,sensitivity,and specificity of Ki67 in diagnosis of endometrial carcinoma were 0. 764,0. 16,64. 29%,and 57. 14%,respectively;AUC,cut-off value,sensitivity,and specificity of Cyr61 in diagnosis of endometrial carcinoma were 0. 760,2. 97,66. 67%,and 42. 86%,respectively;the sensitivity and specificity of joint detection in diagnosis of endometrial carcinoma were 91. 07% and 90. 48%,respectively,which were statistically significantly higher than those of single detection(P<0. 05). Conclusion Hysteroscopy is a safe and effective method in diagnosis of endometrial carcinoma,the diagnostic value of hysteroscopy combined with Ki67 and Cyr61 is higher,which can provide a certain reference for clinical diagnosis and treatment.