血清Cyr61 mRNA、Angptl4 mRNA联合检测对良恶性卵巢囊性病变的鉴别诊断价值

Value of combined detection of serum Cyr61 mRNA and Angptl4 mRNA in differential diagnosis of benign and malignant ovarian cystic lesions

目的探讨血清高半胱氨酸蛋白61(Cyr61)mRNA、血管生成素样蛋白4(Angptl4)mRNA联合检测对良恶性卵巢囊性病变的鉴别诊断价值。方法选取2018年6月至2020年5月在河北北方学院附属第二医院妇科接受治疗的156例卵巢囊性病变患者为研究对象,根据术后病理结果明确病变性质,将患者分为良性卵巢囊性病变患者(良性肿瘤组,82例)和恶性卵巢囊性病变患者(恶性肿瘤组,74例)。采用实时荧光定量PCR检测患者血清Cyr61 mRNA、Angptl4 mRNA的相对表达水平,采用Pearson相关分析恶性卵巢囊性病变患者血清Cyr61 mRNA与Angptl4 mRNA的相关性,分析血清Cyr61 mRNA、Angptl4 mRNA与恶性卵巢囊性病变患者临床病理参数的关系,采用受试者工作特征曲线(ROC曲线)分析血清Cyr61 mRNA、Angptl4 mRNA对良恶性卵巢囊性病变的鉴别诊断价值,采用Logistic回归分析影响恶性卵巢囊性病变发生的因素。结果恶性肿瘤组患者血清Cyr61 mRNA、Angptl4 mRNA的相对表达水平高于良性肿瘤组,差异有统计学意义(P<0.05)。恶性卵巢囊性病变患者血清Cyr61 mRNA与Angptl4 mRNA呈正相关(r=0.612,P<0.05)。恶性卵巢囊性病变患者血清Cyr61 mRNA、Angptl4 mRNA均与肿瘤分化程度、FIGO临床分期、淋巴结转移有关(P<0.05)。血清Cyr61 mRNA、Angptl4 mRNA单独检测鉴别诊断良恶性卵巢囊性病变的ROC曲线下面积(AUC)分别为0.849、0.893,最佳临界值分别为1.278、1.358,特异度分别为78.0%、81.7%,灵敏度分别为78.4%、87.8%;血清Cyr61 mRNA、Angptl4 mRNA联合检测鉴别诊断良恶性卵巢囊性病变的AUC为0.921,特异度为91.5%,灵敏度为85.1%。血清Cyr61 mRNA、Angptl4 mRNA、FIGO临床分期是影响恶性卵巢囊性病变发生的独立危险因素(P<0.05)。结论血清Cyr61 mRNA、Angptl4 mRNA联合检测可能对卵巢囊性病变的良恶性均有一定的鉴别诊断价值。

Objective To investigate the value of combined detection of serum cysteine-rich protein 61(Cyr61)mRNA and angiopoietin like protein 4(Angptl4)mRNA levels in differential diagnosis of benign and malignant ovarian cystic lesions.Methods A total of 156 patients with ovarian cystic lesions who were treated in the Second Hospital Affiliated to Hebei North University from June 2018 to May 2020 were selected as the research objects.According to the postoperative pathological results,the patients were divided into benign ovarian cystic lesions(benign tumor group,82 cases)and malignant ovarian cystic lesions(malignant tumor group,74 cases).The relative expression levels of serum Cyr61 mRNA and Angptl4 mRNA were detected by real-time fluorescent quantitative PCR.The correlation between the relative expression levels of serum Cyr61 mRNA and Angptl4 mRNA in patients with malignant ovarian cystic lesions was analyzed by Pearson correlation.The relationship between serum Cyr61 mRNA,Angptl4 mRNA and clinicopathological parameters in patients with malignant ovarian cystic lesions was analyzed.The value of serum Cyr61 mRNA and Angptl4 mRNA levels in differential diagnosis of benign and malignant ovarian cystic lesions was analyzed by ROC curve,and the factors influencing the occurrence of malignant ovarian cystic lesions were analyzed by Logistic regression analysis.Results The relative expression levels of serum Cyr61 mRNA and Angptl4 mRNA in malignant tumor group were higher than those in benign tumor group(P<0.05).There was a positive correlation between serum Cyr61 mRNA and Angptl4 mRNA in patients with malignant ovarian cystic lesions(r=0.612,P<0.05).The Cyr61 mRNA and Angptl4 mRNA were correlated with tumor differentiation,FIGO clinical stage and lymph node metastasis(P<0.05).The area under the receiver operating characteristic curve(AUC)of single detection of serum Cyr61 mRNA and Angptl4 mRNA in the differential diagnosis of benign and malignant ovarian cystic lesions were 0.849 and 0.893,respectively,the optimal cut-off values were 1.278 and 1.358,respectively,the specificity and sensitivity were 78.0%and 81.7%respectively,78.4%and 87.8%respectively;the AUC of Cyr61 mRNA combined with Angptl4 mRNA was 0.921,the specificity was 91.5%,and the sensitivity was 85.1%.Serum Cyr61 mRNA,Angptl4 mRNA and FIGO clinical stage were independent risk factors for ovarian malignant cystic lesions(P<0.05).Conclusion Combined detection of serum Cyr61 mRNA and Angptl4 mRNA have a certain value in differential diagnosis of benign and malignant ovarian cystic lesions.