血清瘦素及可溶性瘦素受体联合肿瘤标志物对子宫内膜癌的诊断价值

The Diagnostic Value of Serum Leptin and Soluble Leptin Receptor Combined with Tumor Markers in Endometrial Cancer

目的分析血清瘦素(leptin,LEP)、可溶性瘦素受体(sOB-R)、游离瘦素指数(FLI)以及多种肿瘤标志物单独和联合检测对子宫内膜癌的诊断效能,为子宫内膜癌诊断提供参考依据。方法确诊的子宫内膜癌患者136例为研究对象;80例年龄匹配的健康体检女性作为健康对照组;子宫良性疾病女性患者68例,作为良性疾病对照组。收集研究对象基本信息并采集血清标本,ELISA法检测LEP、sOB-R水平;计算FLI值(LEP/sOB-R)。电化学发光法检测各组血清肿瘤标志物水平。比较LEP、sOB-R、FLI和肿瘤标志物在各组间的表达差异。使用Logistic回归分析和ROC曲线比较不同诊断指标的检验效能;用多因素分析多指标联合检测对子宫内膜癌的诊断价值。结果各组中LEP、sOB-R、FLI、CEA、CA125和CA19-9的水平差异有统计学意义(P<0.05)。肿瘤标志物中,CA19-9的检验效能最高(AUC=0.711);LEP相关指标检验效能比较,FLI效能最高(AUC=0.647)。CEA和CA19-9为子宫内膜癌独立危险因素,而sOB-R是子宫内膜癌的保护性因素。sOB-R、CEA和CA19-9联合检测最大约登指数为0.458,AUC等于0.787,灵敏度为55.88%,特异性为89.86%。结论FLI和CA19-9诊断子宫内膜癌的效能较高;sOB-R、CEA和CA19-9联合检测子宫内膜癌具有一定的临床应用价值。

Objective To analyze the value of serum leptin(LEP),soluble leptin receptor(sOB-R),free leptin index(FLI)and multiple tumor markers alone or in combination for the diagnosis of endometrial cancer,so to provide a reference basis for the diagnosis of endometrial cancer.Methods 136 cases of endometrial cancer were diagnosed as the research objects;80 age-matched healthy women were selected as the healthy control group;68 cases of women with benign uterine disease were used as the benign disease control group.We collected the basic information of the research subjects and serum samples,and detected the concentrations of LEP and sOB-R by ELISA method.We then calculated the FLI value(LEP/sOB-R).The level of serum tumor markers in each group was detected by electrochemiluminescence method.The expression differences of LEP,sOB-R,FLI and tumor markers in each group were compared.Logistic regression analysis and ROC curve were used to compare the test efficacy of different diagnostic indicators.Multi-factor analysis and multi-index combined detection were used to evaluate the value of endometrial cancer.Results The levels of LEP,sOB-R,FLI,CEA,CA125 and CA19-9 in each group were statistically significant(P<0.05).Among the tumor markers,CA19-9 had the highest test efficacy(AUC=0.711).Compared with LEP related index test efficacy,FLI efficacy was the highest(AUC=0.647).CEA and CA19-9 were independent risk factors for endometrial cancer,and sOB-R was a protective factor for endometrial cancer.sOB-R,CEA and CA19-9 combined detection had the maximum Youden index 0.458,AUC 0.787,sensitivity 55.88%,and specificity 89.86%.Conclusion The efficacy of FLI and CA19-9 in the diagnosis of endometrial cancer is high.The combined detection of sOB-R,CEA and CA19-9 for endometrial cancer has certain clinical application value.