HE4和PKM2在子宫内膜癌组织中的表达及其与前哨淋巴结转移的相关性

Expression of HE4 and PKM2 in Endometrial Carcinoma and Its Correlation with Sentinel Lymph Node Metastasis

目的探究人附睾分泌蛋白4(HE4)与丙酮酸激酶M2型(PKM2)在子宫内膜癌组织中的表达,并分析上述因子表达与前哨淋巴结转移的相关性。方法选择60例子宫内膜癌患者为研究组,另选同期50例良性子宫内膜病变患者为对照组,对比2组患者组织HE4和PKM2水平;将研究组患者按照病理结果区分为转移组(发生前哨淋巴结转移的子宫内膜癌患者,n=19)和未转移组(未发生前哨淋巴结转移的子宫内膜癌患者,n=41),对比2组患者HE4与PKM2水平,Spearman分析HE4与PKM2表达相关性,最后绘制HE4和PKM2对子宫内膜癌诊断ROC曲线。结果(1)研究组患者的组织HE4和PKM2水平均明显高于对照组患者(P<0.05),前哨淋巴结转移组患者组织HE4与PKM2水平均明显高于未出现淋巴结转移组患者(P<0.05)。(2)Spearman相关性分析显示组织HE4与PKM2水平呈现明显的正相关性(γ=0.8949,P<0.05)。(3)绘制HE4和PKM2对子宫内膜癌的诊断ROC曲线并计算其AUC发现,HE4对子宫内膜癌诊断AUC为0.9464(95%CI为0.8760~1.000,P<0.0001),PKM2对子宫内膜癌诊断AUC为0.9308(95%CI为0.8525~1.000,P<0.0001)。结论HE4和PKM2在子宫内膜癌患者组织中呈高表达,且与淋巴结转移存在密切相关性,可以考虑将HE4和PKM2作为子宫内膜癌诊断指标推广应用于临床。

Objective To investigate the expression of human epididymal secretory protein 4(HE4)and pyruvate kinase M2(PKM2)in endometrial cancer tissues,and to analyze the correlation between the expression of these factors and sentinel lymphatic metastasis.Methods 60 patients with endometrial cancer were selected as the study group,and 50 patients with benign endometrial disease during the same period were selected as the control group.The levels of HE4 and PKM2 in the tissues of the 2 groups of patients were compared,and the patients in the study group were divided into lymph node metastasis group(endometrial cancer patients with sentinel lymph node metastasis,n=19)and non-metastatic group(endometrial cancer patients without sentinel lymph node metastasis,n=41)according to pathological results.The levels of HE4 and PKM2 were compared between the 2 groups.Spearman analyzed correlation between HE4 and PKM2,finally draw the ROC curve of HE4 and PKM2 for the diagnosis of endometrial cancer.Results(1)The tissue HE4 and PKM2 levels of the study group were significantly higher than those of the control group(P<0.05),and the tissue HE4 and PKM2 levels of patients in the sentinel lymph node metastasis group were significantly higher than those in the non-lymph node metastasis group(P<0.05);(2)Spearman correlation analysis showed a significant positive correlation between the levels of HE4 and PKM2 in tissues(γ=0.8949,P<0.05);(3)Draw the ROC curve of HE4 and PKM2 for the diagnosis of endometrial cancer and calculating its AUC found that HE4 diagnosed endometrial cancer AUC was 0.9464(95%CI 0.8760~1.000,P<0.0001),PKM2 diagnosed endometrial cancer AUC was 0.9308(95%CI 0.8525~1.000,P<0.0001).Conclusion HE4 and PKM2 are obviously abnormally high in the tissues of endometrial cancer patients.At the same time,the levels of the above factors are closely related to lymph node metastasis.HE4 and PKM2 can be considered as diagnostic indicators for endometrial cancer to be promoted in clinical applications.