硫氧还蛋白还原酶在宫颈癌中的诊断价值

Diagnostic value of thioredoxin reductase in cervical carcinoma

目的:分析硫氧还蛋白还原酶(thioredoxin reductase,TR)在宫颈癌中的诊断价值。方法:收集2017年10月至2018年5月在我院经病理学确诊的217例宫颈癌患者血浆。所有患者均为初诊,术前未行其他治疗。另收集50例宫颈良性病变和60例健康对照的血浆。TR含量由酶动力学方法检测,均由凯熙医学检验公司完成。采用罗氏电化学发光法检测CEA、CA125、SCC。应用SPSS 19.0统计软件进行分析。血浆TR在宫颈癌患者与良性病变及健康对照组间两两比较采用Mann-Whitney U检验。宫颈癌患者血浆TR与各临床病理特征之间的关系采用非参数秩和检验。宫颈癌患者血浆TR的含量与CEA、CA125和SCC的关系采用Spearman相关性分析,应用ROC曲线及AUC(95%CI)评估它们作为诊断指标的诊断效能。结果:TR在宫颈癌与良性病变及健康对照组间其相对表达量分别为6.78(4.73,9.38)U/ml、3.69(2.65,4.99)U/ml和3.26(2.66,4.28)U/ml。宫颈癌的TR含量显著高于良性病变及健康对照组,差异均有统计学意义(P均<0.001)。宫颈良性病变血浆的TR含量与健康对照者差异无统计学意义(P=0.089)。根据非参数秩和检验,宫颈癌患者血浆TR的含量与年龄、类型和分期均无关(P>0.05)。宫颈癌组与健康对照组比较,TR的敏感度和准确度分别为75.1%和79.8%,高于CEA、CA125和SCC。TR、CEA、CA125、SCC对宫颈癌诊断价值通过AUC表示分别为0.893、0.510、0.769、0.550。四项指标联合诊断AUC值最高为0.946。结论:宫颈癌患者TR血浆浓度明显高于良性病变组及健康对照组,TR对宫颈癌的诊断效能高于CEA、CA125和SCC。四项指标联合检测效能最高。血浆TR可以作为宫颈癌良好的辅助诊断指标。

To analyze the diagnostic value of TR in cervical carcinoma.Methods:Plasma was collected from 217 cases of pathologically confirmed cervical cancer patients in our hospital from October 2017 to May 2018.All the patients were initially diagnosed and no other treatment was performed before the operation.Blood plasma of 50 benign cervical lesions and 60 healthy controls were collected too.TR concentration was detected by enzyme kinetics method,all completed by Kaixi Medical Detection Company.CEA,CA125 and SCC were detected by Roche electrochemical luminescence method.SPSS 19.0 statistical software was used for analysis.TR was compared between cervical cancer and benign lesions and healthy control group using mann-whitney U test.The correlation between plasma TR and pathological features of patients with cervical cancer was examined by the nonparametric rank sum test.Spearman correlation was used to analyze the relationship between plasma TR and CEA,CA125 and SCC in cervical cancer patients,and ROC curve and AUC(95%CI)were used to evaluate their diagnostic efficacy as a diagnostic indicator.Results:The(4.73,9.38)U/ml,3.69(2.65,4.99)U/ml and 3.26(2.66,4.28)U/ml in cervical cancer,benign lesions and healthy control group,respectively.The TR content of cervical cancer was significantly higher than that of benign lesions and healthy control group,and the differences were statistically significant(P<0.001).There was no significant difference in TR content between benign lesions and healthy controls(P=0.089).According to the nonparametric rank sum test,the content of plasma TR in patients with cervical cancer is independent of age,type and stage(P>0.05).The results showed that the sensitivity and accuracy of TR were 75.1%and 79.8%,respectively,higher than CEA,CA125 and SCC.The diagnostic value of TR,CEA,CA125 and SCC for cervical cancer was 0.893,0.510,0.769 and 0.550,respectively,according to AUC.The highest AUC value of the combined diagnosis of the four indicators was 0.946.Conclusion:The plasma concentration of TR in patients of cervical cancer is significantly higher than that of the benign lesions group and the healthy control group,and the diagnostic efficiency of TR to cervical cancer is higher than that of CEA,CA125 and SCC.The combined detection efficiency of the four indicators is the highest.TR can be used as a good diagnostic indicator for cervical cancer.