血清胸苷激酶1联合经阴道超声、宫腔镜对子宫内膜癌的早期诊断价值

Serum TK1 combined with transvaginal sonography and hysteroscopy in the diagnosis of early endometrial cancer

目的:探讨血清胸苷激酶1(TK1)联合经阴道超声(TVS)、宫腔镜对子宫内膜癌(EC)的早期诊断价值。方法:选择疑似子宫内膜癌患者126例,分别行TVS、宫腔镜、血清TK1检查,以术后病理学检查为金标准,比较TVS、宫腔镜、血清TK1分别及三者联合鉴别诊断EC的特异度、敏感度、准确率、阴性及阳性预测值。结果:①经术后病理确诊EC 42例,良性病变84例;②3种方法联合鉴别诊断EC的敏感度、特异度、准确率、阳性及阴性预测值均显著高于TVS、TK1单独检查结果(均P<0.05);联合诊断的特异度、准确率、阳性预测值均高于宫腔镜单独检查(均P<0.05)。③ROC曲线分析,EC与非EC患者血清TK1水平临界值为2.015 pmol/L,AUC为0.774,渐进95%置信区间为(0.822,0.834),其敏感度、特异度分别为61.90%(26/42)、71.43%(60/84)。结论:血清TK1检测与TVS、宫腔镜联合应用有助于临床早期诊断EC。

Objective:To explore the value of serum thymidine kinase 1(TK1)expression combined with transvaginal sonography(TVS)and hysteroscopy in the early diagnosis of endometrial cancer(EC).Methods:126 patients with suspected EC were selected.TVS,hysteroscopy,and serum TK1 examinations respectively were performed,with postoperative pathological examination as the gold standard.The specificity,sensitivity,accuracy,negative and positive predictive value of TVS,hysteroscopy,and serum TK1 respectively and combined differential diagnosis of EC and non-EC were compared.Results:42 cases were EC,and 84 cases were benign lesions.The sensitivity,specificity,accuracy,positive and negative predictive value of serum TK1 combined with TVS and hysteroscopy in differential diagnosis of EC were significantly higher than those of TVS and TK1 alone(all P<0.05).The specificity,accuracy,and positive predictive value of combined examination were higher than those of hysteroscopy alone(all P<0.05).ROC curve statistics showed that the cut-off value of serum TK1 level in EC and non-EC patients was 2.015 pmol/L,AUC was 0.774,and the progressive 95%CI was(0.822,0.834).The sensitivity and specificity were 61.90%(26/42)and 71.43%(60/84),respectively.Conclusion:The combination of TK1 detection,TVS and hysteroscopy is helpful for early diagnosis of EC.