卵巢癌患者血清及尿液中中性粒细胞明胶酶相关脂质运载蛋白表达水平及临床意义

Expression level and clinical significance of neutrophil gelatinase associated lipocalin in serum and urine in patients with ovarian neoplasms

目的探讨中性粒细胞明胶酶相关脂质运载蛋白(NGAL)在卵巢癌患者血清及尿液中的表达水平及临床意义。方法患者分为恶性组、交界性组、良性组和正常组;用ELISA法测定170例女性血清及尿液中NGAL水平,分析对卵巢恶性肿瘤的诊断价值。结果卵巢恶性肿瘤组血清及尿NGAL水平均高于卵巢交界性肿瘤组、良性组和正常组;交界性组血清NGAL水平高于良性组及正常组,而其尿NGAL水平仅高于正常组;当血清NGAL在33.59ng/mL时诊断指数最大(0.642),敏感性和特异性分别为95.7%和68.5%,ROC曲线下面积为0.897;当尿NGAL在12.18ng/mL时诊断指数最大(0.512),敏感性和特异性分别为60.9%和90.3%,ROC曲线下面积为0.821;卵巢癌患者血与尿NGAL呈正相关(r=0.678);无论早期或晚期卵巢癌,血和尿NGAL阳性率的差异均无统计学意义。结论NGAL可作为卵巢癌诊断的生物学指标之一,血清NGAL≥33.59ng/mL、尿NGAL≥12.18ng/mL时对卵巢恶性肿瘤的诊断指数最大,尿NGAL水平测定可作为卵巢癌普查方法之一。

Objective To explore the expression level and clinical significance of neutrophil gelatinase associated lipocalin(NGAL)in serum and urine in patients with ovarian neoplasms.Methods The patients were divided into malignant group,borderline group,benign group and normal group.NGAL levels in serum and urine of 170female patients were detected by ELISA method,and its diagnostic value for ovarian malignant tumor was analyzed.Results The serum NGAL levels of ovarian neoplasms group were higher than those of ovarian borderline group,benign group and normal group.The serum NGAL levels of borderline group wase higher than those of benign group and normal group.Urine NGAL level of ovarian neoplasms group was higher than that of normal group.When the serum NGAL was 33.59 ng/mL,the diagnostic index was the highest(0.642),the sensitivity and specificity were 95.7%and 68.5%,respectively,and the area under the ROC curve was 0.897.When the urinary NGAL was 12.18ng/mL,the diagnostic index was the highest(0.512),the sensitivity and specificity were 60.9%and 90.3%,respectively,and the area under the ROC curve was 0.821.There was a positive correlation between serum and urine NGAL in ovarian neoplasms patients(r=0.678).There was no significant difference for the positive rates of serum and urine NGAL in early or later stage patients.Conclusion NGAL level can be used as one of the biological indicator for ovarian cancer diagnosis.The diagnostic index was the highest when cut off value for 33.59ng/mL in serum and 12.18ng/mL in urine.Detection of urinary NGAL level can be used for screening of ovarian cancer.