血清HE4、PTX-3和TPS联合检测对卵巢癌的早期诊断价值

The value of serum HE4,PTX-3 and TPS in early diagnosis of ovarian cancer

目的探讨卵巢癌患者血清人附睾分泌蛋白4(HE4)、正五聚蛋白-3(PTX-3)和组织多肽特异性抗原(TPS)浓度及其早期诊断、预后的价值。方法选取2015年2月至2019年2月武汉科技大学附属普仁医院诊治的105例上皮性卵巢癌患者作为研究对象,并设为卵巢癌组。另收集同期在武汉科技大学附属普仁医院体检中心体检的70例健康体检者设为对照组。采用电化学发光法检测血清HE4浓度,酶联免疫吸附试验法检测PTX-3、TPS浓度。利用受试者工作曲线计算血清HE4、PTX-3和TPS浓度对卵巢癌的诊断价值,Kaplan-Meier法绘制卵巢癌患者生存曲线,Cox多因素回归分析影响卵巢癌患者的危险因素。结果卵巢癌组血清HE4为(31.27±10.42)pmol/L、PTX-3为(7.04±1.96)g/L、TPS为(81.50±22.78)U/L,均明显高于对照组的(19.86±8.70)pmol/L、PTX-3(4.58±1.87)g/L、TPS(48.25±14.85)U/L,差异具有统计学意义(t=7.568、8.257、10.773,P<0.05)。血清HE4鉴别卵巢癌组和对照组的AUC为0.803,PTX-3为0.829,TPS为0.886,HE4+PTX-3+TPS联合为0.944,HE4+PTX-3+TPS联合诊断均明显高于HE4、PTX-3、TPS单独检测,差异具有统计学意义(Z=4.602、3.855、3.137,P﹤0.05)。Cox多因素回归分析显示,HE4、PTX-3、TPS是影响卵巢癌组预后的独立因素(P<0.05)。血清HE4、PTX-3、TPS高浓度组5年生存率均明显低于低浓度组,差异具有统计学意义(χ^(2)=11.154、8.836、17.952,P<0.05)。结论卵巢癌患者血清HE4、PTX-3、TPS明显升高,HE4、PTX-3、TPS可作为卵巢癌早期诊断及预后评估的肿瘤标志物。

Objective To investigate the values of serum concentrations of human epididymal protein 4(HE4),pentraxins-3(PTX-3)and tissue polypeptide specific antigen(TPS)in early diagnosis and prognosis of ovarian cancer.Methods 105 patients with epithelial ovarian cancer from February 2015 to February 2019 in the Affiliated Hospital of Wuhan University of Science and Technology,Wuhan Puren Hospital were selected as the research objects and set as ovarian cancer group.Another 70 healthy people who had physical examination in the Medical Examination Center of the Affiliated Hospital of Wuhan University of Science and Technology,Wuhan Puren Hospital during the same period were selected as the control group.Serum HE4 concentration was detected by electrochemical luminescence method,and the concentrations of PTX-3 and TPS were detected by enzyme-linked immunosorbent assay.The subject work curve was used to calculate the diagnostic value of serum HE4,PTX-3 and TPS concentrations for ovarian cancer.Kaplan-Meier method was used to draw the survival curve of ovarian cancer patients.Cox multivariate regression analysis was used to analyze the risk factors affecting ovarian cancer patients.Results The serum HE4,PTX-3 and TPS levels in the ovarian cancer group were(31.27±10.42)pmol/L,(7.04±1.96)g/L and(81.50±22.78)U/L,which were significantly higher than those in the control group(19.86±8.70)pmol/L,PTX-3(4.58±1.87)g/L and TPS levels(48.25±14.85)U/L,with statistically significant differences(t=7.568,8.257 and 10.773,P<0.05).The AUC,PTX-3 and TPS of serum HE4 in differentiating ovarian cancer patients from the control group were 0.803,0.829 and 0.886 respectively,and the combined HE4+PTX-3+TPS was 0.944.The combined diagnosis of HE4+PTX-3+TPS was significantly higher than that of HE4,PTX-3 and TPS alone,and the differences were statistically significant(Z=4.602,3.855 and 3.137,P<0.05).Cox multivariate regression analysis showed that HE4,PTX-3 and TPS were independent factors affecting the prognosis of patients with ovarian cancer(P<0.05).The 5-year survival rate of patients in the high concentration group of serum HE4,PTX-3 and TPS was significantly lower than that in the low concentration group(χ^(2)=11.154,8.836,17.952,P<0.05).Conclusions The serum levels of HE4,PTX-3 and TPS in ovarian cancer patients are significantly increased,and HE4,PTX-3 and TPS can be used as tumor markers for early diagnosis and prognosis of ovarian cancer.