宫颈癌患者血清叶酸受体-1表达水平及早期诊断价值

Expression level of serum folate receptor-1 in patients with cervical cancer and its early diagnostic value

目的 探讨血清叶酸受体-1(叶酸受体-1)作为生物标志物在宫颈癌早期诊断中的价值。方法 收集2017年1月至2019年1月在南充市第五人民医院门诊(下称该院)行宫颈脱落细胞学检查136例人乳头瘤病毒(HPV)感染患者临床资料,经病理组织学确诊为宫颈上皮内瘤变组58例和宫颈癌组78例;另选择该院同期52例体检的健康女性作为健康对照组。收集3组研究对象临床资料,包括年龄、FOLR1水平、HPV感染、HPV16型感染、孕次、流产史、肿瘤家族史等。分析血清FOLR1表达与宫颈癌组临床病理资料关系。采用酶联免疫吸附法检测血清FOLR1,利用受试者工作曲线(ROC)评价血清FOLR1对宫颈癌的诊断效能。结果 3组研究对象在年龄、FOLR1水平、HPV感染、HPV16型感染比较,差异具有统计学意义(P<0.05);而在孕次、流产史、肿瘤家族史比较,差异无统计学意义(P>0.05)。血清FOLR1水平与年龄、病理类型、组织分化、FLGO分期、淋巴结转移有关(P<0.05);血清FOLR1水平与孕次、流产史、肿瘤家族史无关,差异无统计学意义(P>0.05)。宫颈癌组血清FOLR1水平(271.68±109.38)ng/L明显高于宫颈上皮内瘤变组r (141.08±60.05)ng/L、健康对照组的(124.52±50.17)ng/L,差异具有统计学意义(t=8.214、8.587,P<0.001),而宫颈上皮内瘤变组与健康对照组比较,差异无统计学意义(P>0.05)。血清FOLR1鉴别宫颈癌和宫颈上皮内瘤变的AUC为0.884,灵敏度为81.03%,特异度为79.49%;血清FOLR1鉴别宫颈癌和健康对照组的AUC为0.946,灵敏度为84.62%,特异度为92.31%。结论 宫颈癌患者血清FOLR1水平明显升高,高水平表达FOLR1与患者年龄、病理类型、组织分化、FLGO分期、淋巴结转移有关,血清FOLR1可作为宫颈癌早期诊断指标之一。

Objective To investigate the value of serum folate receptor-1(FOLR1)as a biomarker in the early diagnosis of cervical cancer.Methods The clinical data of 136 patients with HPV infection who were examined by cervical exfoliative cytology in the Fifth People′s Hospital of Nanchong from January 2017 to January 2019 were collected.According to histopathological diagnosis,58 cases were classified into cervical intraepithelial neoplasia group and 78 cases were cervical cancer group.Another 52 healthy women who were examined in the hospital at the same time were selected as healthy control group.The clinical data of the subjects were collected,including age,FOLR1 level,HPV infection,type 16 HPV infection,pregnancy,abortion history,tumor family history,etc.The relationship between serum FOLR1 expression and clinicopathological data of cervical cancer were analyzed.Serum FOLR1 was detected by enzyme-linked immunosorbent assay(ELISA),and the diagnostic performance of serum FOLR1 in cervical cancer was evaluated by receiver operating curve(ROC).Results The differences in age,FOLR1 level,HPV infection,and 16 HPV infection were statistically significant among the three groups(P<0.05),while there was no significant difference in pregnancy,abortion history,and family history of cancer(P>0.05).Serum FOLR1 levels were associated with age,pathological type,tissue differentiation,FLGO stage,lymph node metastasis(P<0.05),but not with pregnancy,abortion history,or tumor family history(P>0.05).The serum FOLR1 content(271.68±109.38)ng/L in cervical cancer group was significantly higher than that in cervical intraepithelial neoplasia group(141.08±60.05)ng/L,and healthy control group(124.52±50.17)ng/L(P<0.05),while there was no significant difference between the cervical intraepithelial neoplasia group and the healthy control group(P>0.05).The AUC of serum FOLR1 for differential diagnosis of cervical cancer and cervical intraepithelial neoplasia was 0.884,sensitivity was 81.03%,and specificity was 79.49%.The AUC of serum FOLR1 for differential diagnosis of cervical cancer and healthy people was 0.946,sensitivity was 84.62%,and specificity was 92.31%.Conclusion FOLR1 levels of patients with cervical cancer are significantly elevated.High level of FOLR1 was associated with age,pathological type,tissue differentiation,FLGO stage,and lymph node metastasis.Serum FOLR1 level may be used as an early diagnostic indicator for cervical cancer.