经阴道彩色多普勒超声联合血清IL-37和SCCA诊断宫颈癌的临床应用价值

Clinical value of transvaginal color Doppler ultrasound combined with serum IL-37 and SCCA in the diagnosis of cervical cancer

目的探究经阴道彩色多普勒超声(TVCDS)联合血清IL-37、SCCA诊断宫颈癌的临床应用价值。方法选取2013年7月至2019年8月于九江市第一人民医院妇科或肿瘤科就诊且经病理组织学明确诊断的宫颈癌患者37例作为宫颈癌组,25例宫颈上皮内瘤变(CIN)患者作为疾病对照组以及27例子宫良性病变患者作为良性疾病组。所有研究对象均行TVCDS检查。酶联免疫吸附试验测定血清IL-37水平,电化学发光发测定SCCA浓度。比较3组临床资料,血清IL-37、SCCA和血流RI情况,分析血清IL-37与宫颈癌临床病理学参数的关系,探讨各指标单独检测及联合检测的诊断学性能。结果宫颈癌患者血清IL-37异常上调,显著高于CIN组和正常组[(93.72±29.04)ng/mL vs.(26.65±12.29)pg/mL或(23.03±13.40)pg/mL,P<0.05]。宫颈癌组SCCA显著高于CIN组,均高于正常组。宫颈癌组血流RI显著低于CIN组,均低于正常组。淋巴结转移患者血清IL-37显著高于淋巴结未转移者,ⅡA~ⅢB期患者血清IL-37显著高于IA~ⅠB患者。联合TVCDS、IL-37和SCCA可显著提高宫颈癌的诊断灵敏度(88.35%)、特异性(92.05%)、阴阳性预测值(79.37%和87.89%)、约登指数(0.80)以及ROCAUC(0.88)。结论血清IL-37在宫颈癌中表达异常上调,且与肿瘤分期和淋巴结转移密切相关;联合TVCDS、IL-37和SCCA可显著提高宫颈癌的诊断准确性。

Objective To explore the clinical value of transvaginal color Doppler sonography(TVCDS)combined with serum IL-37 and SCCA in the diagnosis of cervical cancer.Methods 37 cervical cancer patients who were diagnosed by patho-histology at the Department of Gynecology or Oncology of Jiujiang First People's Hospital from July 2013 to August 2019 were selected as the cervical cancer group,25 patients with cervical intraepithelial neoplasia(CIN)as disease control group and 27 patients with benign uterine lesions as normal group.All subjects were examined by TVCDS.Serum IL-37 levels were determined by ELISA and SCCA concentrations were determined by electrochemiluminescence.Compare the three groups of clinical data,serum IL-37,SCCA and blood flow RI,analyze the relationship between serum IL-37 and clinical pathological parameters of cervical cancer,and explore the diagnostic performance of each index individually and combined.Results The abnormal up-regulation of serum IL-37 in cervical cancer patients was significantly higher than those in CIN group and normal group[(93.72±29.04)ng/mL vs.(26.65±12.29)pg/mL or(23.03+13.40)pg/mL,P<0.05].SCCA in cervical cancer group was also significantly higher than that in CIN group,and higher than that in normal group.In addition,RI of blood flow in cervical cancer group was significantly lower than that in CIN group,and were lower than that in normal group.Serum IL-37 was significantly higher in patients with lymph node metastasis than in patients without lymph node metastasis,and also significantly higher in patients with stageⅡA-ⅢB than in patients withⅠA-ⅠB.The combination of TVCDS,IL-37 and SCCA could significantly improve the diagnostic sensitivity(88.35%),specificity(92.05%),negative and positive predictive values(79.37%and 87.89%),Yoden index(0.80)and ROCAUC(0.88).Conclusion Serum IL-37 expression is abnormally up-regulated in cervical cancer,which is closely related to tumor stage and lymph node metastasis.The combination of TVCDS,IL-37 and SCCA can significantly improve the diagnostic accuracy of cervical cancer.