肿瘤标志物和HPV检测在宫颈癌诊断中的价值及相互关系

Significance and correlation of tumor markers and HPV detection for the diagnosis of cervical cancer

目的探讨癌胚抗原(CEA)、糖类抗原199(CA199)和人乳头瘤病毒(HPV)检测在宫颈癌诊断中的价值及其相互关系。方法选取2017年2月至2019年2月间西安医学院附属宝鸡医院收治的120例宫颈癌患者为宫颈癌组,选取同期105例宫颈炎患者为良性病变组,选取同期体格检查的100例健康女性为对照组。检测三组受试者血清CEA和CA199浓度,采用全自动聚合酶链反应(PCR)法检测三组受试者宫颈分泌物HPV阳性率,并实施组间比较。宫颈癌组患者按病程分为早期病变组(87例)与晚期病变组(33例),比较两组患者血清CEA、CA199水平和HPV阳性率,分析三者对宫颈癌诊断的一致性、特异度、灵敏度及相互关系。结果宫颈癌组患者血清CEA、CA199水平及HPV阳性率均高于良性病变组,两组均高于对照组,各组间比较,差异均有统计学意义(均P <0.05)。宫颈癌晚期病变组患者血清CEA、CA199和HPV阳性率均较早期病变组更高,差异均有统计学意义(均P <0.05)。以病理诊断为金标准,血清CEA、CA199和HPV阳性率对宫颈癌诊断的一致性、特异度和灵敏度比较,差异均无统计学意义(P> 0.05)。相关性分析显示,血清CEA、CA199水平与HPV阳性率表达均呈正相关(均P <0.05)。结论 CEA、CA199和HPV在宫颈癌诊断中有良好的应用价值,可用于宫颈癌初步筛查。

Objective To explore the value of carcinoembryonic antigen( CEA),carbohydrate antigen 199( CA199) and human papilloma virus( HPV) detection for the diagnosis of cervical cancer,and to explore the relationship between the above factors. Methods One hundred and twenty patients with cervical cancer who were treated at Xi’an Medical University Affiliated Baoji Hospital from February 2017 to February 2019 were selected as the cervical cancer group. Another 105 patients with benign cervical tumors who were treated at the same hospital during the same period were selected as the benign lesion group. One hundred healthy individuals undergoing physical examination at the same hospital were selected as a control group. The serum CEA and CA199 concentrations were detected respectively in the three groups. Polymerase chain reaction( PCR) was used to detect positive rate of HPV expression in cervical secretions in the three groups,and a comparison was performed among the groups. Patients with cervical cancer included 87 patients with early-stage lesions and 33 patients with advanced lesions. The positive rate of serum CEA,CA199 levels and HPV was compared among the groups. The consistence,specificity,specificity and sensitivity of CEA,CA199 and HPV detection for the diagnosis of cervical cancer were analyzed. Results The levels of serum CEA,CA199 and HPV were significantly higher in the cervical cancer group than in the benign lesion group,and the benign lesion group was significantly higher than the control group( all P <0. 05). The positive rates of serum CEA,CA199 and HPV were higher in patients with advanced lesions than in patients with early-stage lesions( all P < 0. 05). There was no significant difference in consistency,specificity,and sensitivity between serum CEA,CA199,and positive rates of HPV and pathological diagnosis for cervical cancer diagnosis( P > 0. 05). Correlation analysis found that serum CEA and CA199 levels were positively associated with positive rate of HPV expression( P < 0. 05). Conclusion CEA,CA199 and HPV detection is effective for the diagnosis of cervical cancer and can be used for the preliminary screening of cervical cancer.