卵巢癌患者血清HE4和Ki67水平的诊断价值及与临床病理特征和预后的关系

Diagnostic value of serum HE4 and Ki67 levels in patients with ovarian cancer and their relationship with clinicopathological features and prognosis

目的检测卵巢癌患者血清人附睾蛋白4(HE4)和细胞核相关抗原Ki67水平,分析其对卵巢癌的诊断价值,及与临床病理特征和预后的关系。方法选取2016年3月至2019年3月苏州市立医院诊治的56例卵巢癌患者纳入卵巢癌组,选取同期40例卵巢良性病变患者纳入良性组,选取同期40例体检健康女性纳入对照组。检测研究对象血清HE4、Ki67水平。以受试者操作特征(ROC)曲线下面积(AUC)评价血清HE4、Ki67水平对卵巢癌患者诊断价值。采用单因素分析和多元Logistic回归模型分析卵巢癌患者血清HE4、Ki67水平与临床病理特征的关系。采用Kaplan-Meier生存曲线分析卵巢癌患者血清HE4、Ki67水平与预后的关系。结果卵巢癌组血清HE4、Ki67水平均高于良性组和对照组(P<0.05)。血清HE4诊断卵巢癌AUC为0.730,血清Ki67诊断卵巢癌AUC为0.723,两者联合诊断卵巢癌AUC为0.812。组织学分化程度、FIGO分期、淋巴结转移是血清HE4高水平的影响因素。FIGO分期、淋巴结转移是血清Ki67高水平的影响因素。截至2020年3月,56例随访患者死亡30例。其中HE4≥140pmol/L患者中位生存时间为21个月,<140pmol/L患者为43个月。Ki67≥50pg/mL患者中位生存时间为23个月,<50pg/mL患者为44个月。结论卵巢癌患者存在血清HE4、Ki67水平的升高。血清HE4、Ki67水平能够作为诊断卵巢癌的指标,两者联合诊断价值更高。血清HE4<140pmol/L、Ki67<50pg/mL患者预后相对较好。

Objective To detect the diagnostic value of serum human epididymis protein 4(HE4) and Ki67 levels in patients with ovarian cancer and their relationship with clinicopathological features and prognosis. Methods 56 patients with ovarian cancer diagnosed and treated in Suzhou Municipal Hospital from March 2016 to March 2019 were included in the ovarian cancer group, 40 patients with benign ovarian lesions during the same period were included in the benign group, and 40 healthy women during the same period were included in the control group. Serum HE4 and Ki67 levels were detected. The diagnostic value of serum HE4 and KI67 levels in ovarian cancer patients was evaluated by the area under receiver operating characteristic(ROC) curve(AUC). Univariate analysis and multiple Logistic regression model were used to analyze the relationship between serum HE4 and Ki67 levels and clinicopathological characteristics of ovarian cancer patients. Kaplan-Meier survival curve was used to analyze the relationship between serum HE4 and Ki67 levels and prognosis of ovarian cancer patients. Results Serum levels of HE4 and Ki67 in ovarian cancer group were higher than those in benign group and control group(P<0.05).The AUC of serum HE4 in ovarian cancer was 0.730, that of serum Ki67 in ovarian cancer was 0.723, and that of the combined diagnosis of ovarian cancer was 0.812.The degree of histological differentiation, FIGO stage and lymph node metastasis were the influencing factors for the high serum HE4 level. FIGO stage and lymph node metastasis were the influencing factors of high serum Ki67 level. By March 2020, 30 of 56 follow-up patients had died. The median survival time of patients with HE4≥140 pmol/L was 21 months, and that of patients with HE4<140 pmol/L was 43 months. The median survival time was 23 months for patients with Ki67≥50 pg/mL and 44 months for patients with Ki67<50 pg/mL. Conclusions Patients with ovarian cancer have elevated serum HE4 and Ki67 levels. Serum HE4 and Ki67 levels can be used as indicators for the diagnosis of ovarian cancer, and their combined diagnostic value is higher. Patients with serum HE4<140 pmol/L and Ki67<50 pg/mL had better prognosis.