超声造影定量分析与血清SIRT1、HMGB1水平对卵巢癌淋巴结转移的预后价值

Value of the results of quantitative contrast-enhanced ultrasound and the levels of serum silent mating type information regulation2 homolog 1 and high mobility group box 1 for predicting the lymph node metastasis of patients with ovarian cancer

目的:分析超声造影参数、血清沉默信息调控子1(SIRT1)、高迁移率族蛋白B1(HMGB1)水平与卵巢癌淋巴结转移的关系。方法:收集2016年6月-2019年12月在本院确诊的卵巢癌患者96例临床资料,分为淋巴结转移组42例、非淋巴结转移组54例;健康体检卵巢正常女性96例为对照组。行彩色超声造影定量分析,酶联免疫吸附试验检测血清SIRT1、HMGB1水平;比较各组超声造影参数;分析造影定量分析参数、血清SIRT1、HMGB1水平诊断卵巢癌淋巴结转移价值。结果:与对照组比较,淋巴结转移组、非淋巴结转移组造影剂到达时间、灌注时间无差异(P>0.05),达峰时间、基础强度降低,淋巴结转移组增强强度升高,淋巴结转移组达峰时间、基础强度低于非淋巴结转移组(均P<0.05);对照组、非淋巴结转移组、淋巴结转移组血清SIRT1水平依次降低,血清HMGB1水平依次升高(P<0.05)。受试者工作曲线分析显示,超声造影参数达峰时间、基础强度、血清SIRT1和HMGB1水平诊断卵巢癌淋巴结转移均有一定价值,但各项联合诊断价值最高,AUC为0.952,敏感度为92.6%,特异性为92.9%;logistic回归分析表明,达峰时间、基础强度、HMGB1是卵巢癌淋巴结转移的危险因素,血清SIRT1是卵巢癌淋巴结转移的保护因素。结论:超声造影定量分析联合血清SIRT1、HMGB1检测诊断卵巢癌淋巴结转移效能较高,可为临床卵巢癌治疗预后提供参考依据。

Objective:To detect the serum silent mating type information regulation 2 homolog 1(SIRT1)and high mobility group box 1(HMGB1)levels of the patients with ovarian cancer,and to analyze relationship between the parameters of contrast-enhanced ultrasound(CEUS),and the serum SIRT1 and HMGB1 levels of patients and their lymph node metastasis.Methods:The clinical data of a total of 96 patients with ovarian cancer from June 2016 to December 2019 were collected in study group,which included 42 patients with lymph node metastasis in group A and 54 patients without lymph node metastasis in group B.Another 96 women without ovarian cancer were included in control group.The quantitative analysis of contrast-enhanced color ultrasound was performed on all of these patients.The levels of serum SIRT1 and HMGB1 were detected by enzyme linked immunosorbent assay(ELISA).The parameters of contrast-enhanced ultrasound of the patients were compared among these groups.The values of the parameters of quantitative analysis by contrast-enhanced ultrasound and the serum SIRT1 and HMGB1 levels for diagnosing the lymph node metastasis of ovarian cancer were analyzed.Results:There were no significant differences in the arrival time and perfusion time of contrast agent of the patients among the control group,group A,and group B(P>0.05),but the peak time and basic intensity of contrast agent of the patients in group A and group B were significantly less than those of the patients in the control group.The enhanced intensity of contrast agent of the patients in group A significantly higher than that of the patients in group B,but the peak time and basic intensity of contrast agent of the patients in group A were significantly lower(all P<0.05).The serum SIRT1 level of the patients in the control group,group B,and group A had decreased gradually,but the serum HMGB1 level of the patients in the control group,group B,and group A had increased gradually(P<0.05).The analysis of receiver operator characteristic curve showed that the peak time and the basal intensity of the parameters by contrast-enhanced ultrasound,and the serum SIRT1 and HMGB1 levels had certain values for diagnosing the lymph node metastasis of ovarian cancer.The combination of the parameters by contrast-enhanced ultrasound and the serum SIRT1 and HMGB1 levels had the highest diagnosis value,which AUC,sensitivity,and specificity were 0.952,92.6%,and 92.9%,respectively.Logistic regression analysis showed that the peak time and the basal intensity of the parameters by contrast-enhanced ultrasound,and the serum HMGB1 level were the risk factors of the lymph node metastasis of ovarian cancer,and the serum SIRT1 level was a protective factor of the lymph node metastasis of ovarian cancer.Conclusion:Quantitative analysis of contrast-enhanced ultrasound combined with the levels of serum SIRT1 and HMGB1 can improve the diagnostic efficiency of the lymph node metastasis of ovarian cancer,which can provide the evidences for evaluating the prognosis after clinical diagnosis and treatment.