血清HE4和CA724水平对子宫内膜癌的诊断及淋巴转移的预测价值

Clinical diagnostic significance of serum HE4 and CA724 levels in endometrial cancer and its predictive value for lymphatic metastasis

目的评价探讨新型肿瘤标志物血清人附睾分泌蛋白E4(HE4)和CA724浓度对术前子宫内膜癌的临床诊断意义以及术前预测淋巴结转移的风险价值。方法对子宫内膜癌患者的数据进行回顾性研究分析,选取了2016年6至2018年6接受手术治疗的患者(96例)为CA组,并且术前测量血清HE4和和胃癌抗原(CA724)水平的患者,并对其临床病理特征和病例资料进行分析,同时与同期选取健康体检者(CT组,86例)血清作对比。结果CA组患者血清HE4和CA724浓度显著高于CT组(均P<0.05);在子宫内膜癌患者中,大病灶患者(≥2 cm),肌层浸润深(≥50%)以及晚期疾病分期或淋巴结转移的患者血清HE4和CA724浓度均显着升高(P<0.05)。对于淋巴结转移,HE4具有较高的敏感性和阴性预测值。HE4和CA724的组合诊断性能优越单独使用任何一种标记。结论血清HE4和CA724的联合评价可明显提高子宫内膜癌的诊断准确性,同时可以为临床术者是否进行淋巴结清扫提供新的肿瘤标志物参考。

Objective To evaluate the clinical diagnostic significance of novel tumor markers-serum human epididymal secretory protein E4(HE4)and CA724 in endometrial cancer(EC)and their value in predicting the risk of lymph node metastasis before surgery.Methods The data about 96 patients with EC were retrospectively analyzed.The 96 patients who underwent surgery in our hospital from June 2016 to June 2018 were enrolled as CA group.The serum levels of HE4 and CA724 were detected before surgery.The clinicopathological characteristics and medical records of the patients were analyzed and compared with the serum levels of healthy subjects,who enrolled as CT group(n=86)at the same period.Results The serum levels of HE4 and CA724 in CA group were significantly higher than those in CT group(P<0.05).The serum levels of HE4 and CA724 were significantly increased in EC patients with large lesions(≥2cm),deep muscular infiltration(≥50%),advanced disease stage or lymph node metastasis(P<0.05).For lymph node metastasis,HE4 had higher sensitivity and negative predictive value.The diagnostic performance of combination detection of HE4 and CA724 was superior to that by any marker alone.Conclusion The combined evaluation of serum HE4 and CA724 can significantly improve the diagnostic accuracy for EC,meanwhile,which can provide a reference in terms of novel tumor markers for clinicians to perform lymph node dissection.