血清AFP、CEA、CA199和CA125联合检测在宫颈癌诊断中的价值

Value of Combined Detection of Serum AFP,CEA,CA199 and CA125 in Diagnosis of Cervical Cancer

目的探讨甲胎蛋白(AFP)、癌胚抗原(CEA)、糖类抗原(CA)199及CA125联合检测在宫颈良恶性病变诊断中的应用价值。方法收集2002年12月至2017年3月在中国中医科学院望京医院妇科就诊的83例患者作为研究对象,按照病理检查结果分为宫颈癌组(43例)和宫颈上皮内瘤变组(40例),分析血清AFP、CEA、CA199和CA125联合检测对宫颈癌诊断的价值。结果宫颈癌组患者血清AFP、CEA、CA199、CA125水平显著高于宫颈上皮内瘤变组(P<0.05)。ⅠB2~ⅡB期宫颈癌患者血清AFP、CEA、CA199、CA125表达水平均显著高于ⅠA~ⅠB1期宫颈癌患者(P<0.01)。血清AFP、CEA、CA199、CA125水平对宫颈癌患者均具有一定的检测能力(P<0.01)。其中,CA125曲线下面积(AUC)最大(0.710),AFP(AUC=0.691)、CEA(AUC=0.687)、CA199(AUC=0.674)的检测效能较弱。用Logistic回归计算联合诊断的概率P,用P绘制受试者工作特征曲线并计算AUC为0.764,提示血清AFP、CEA、CA199、CA125联合检测能提高对宫颈癌患者的诊断价值。结论血清CEA、AFP、CA199和CA125联合检测对宫颈癌诊断具有一定的临床价值,其能提高宫颈癌诊断的准确性。

Objective To explore the value alpha-fetoprotein(AFP),carcinoembryonic antigen(CEA),carbohydrate antigen(CA)199 combined with CA125 examination in the diagnosis of cervical cancer.Methods A retrospective study was carried out on 83 patients in Wangjing Hospital of China Academy of Chinese Medical Sciences from Dec.2002 to Mar.2017.According to the results of pathological examination,the patients were divided into a cervical cancer group(43 cases)and cervical intraepithelial neoplasia group(40 cases).The value of combined detection of serum AFP,CEA,CA199 and CA125 in the diagnosis of cervical cancer was analyzed.Results The serum levels of AFP,CEA,CA199 and CA125 in the cervical cancer group were significantly higher than those in cervical intraepithelial neoplasia group(P<0.05).The levels of serum AFP,CEA,CA199 and CA125 in patients with stageⅠB2-ⅡB cervical cancer were significantly higher than those in patients with stageⅠA-ⅠB1 cervical cancer(P<0.01).The serum levels of AFP,CEA,CA199 and CA125 all had a certain detection ability for cervical cancer(P<0.01).Among them,CA125 had the largest area under curve(AUC)value(AUC=0.710),AFP(AUC=0.691),CEA(AUC=0.687),CA199(AUC=0.674)detection efficiency was weaker.Logistic regression was used to calculate the probability P of joint diagnosis,receiver operating characteristic curve was drawn with P and the area under the curve(AUC=0.764)was calculated,which suggested that the combined detection of serum AFP,CEA,CA199 and CA125 could improve the diagnosis of cervical cancer.Conclusion Combined detection of serum CEA,AFP,CA125 and CA199 have a certain clinical value for the diagnosis of cervical cancer,which can improve the diagnostic accuracy.