血液学指标在子宫内膜异位症相关性卵巢癌早期诊断中的研究

Significances of hematology indexes in the early diagnosis of endometriosis associated ovarian cancer

目的分析血液学指标在子宫内膜异位症患者与子宫内膜异位症相关性卵巢癌(EAOC)患者中的差异,探讨对内异症恶变具有诊断价值的临床指标。方法比较子宫内膜异位症患者与子宫内膜异位症相关性卵巢癌患者外周血指标(NEUT%、LYM%、MXD%、EO%、NEUT#、LYM#、MXD#、WBC、PLT、TBIL、DBIL、IBIL、ALB、CRP、CA125、HE4、NLR、MLR、PLR、ELR、CRP/ALB、SII、SIRI)的水平差异,并通过Logistic回归分析构建联合诊断指标。结果子宫内膜异位症相关性卵巢癌患者WBC、NEUT%、NEUT#、CA125、HE4、NLR、SII、SIRI均高于内异症组(P<0.05),内异症患者LYM%、ALB高于EAOC组(P<0.05)。调整了NEUT%、CA125、NLR、SII、SIRI、LYM%的影响后,WBC(P=0.023)、NEUT#(P=0.014)、HE4(P<0.001)、ALB(P=0.045)与内异症恶变发生显著相关。通过绘制ROC曲线发现,WBC、NEUT#、HE4联合诊断内异症恶变AUC(0.831)大于各指标单独诊断,并具有较高的灵敏度(81.10%)。结论WBC、NEUT#、HE4联合诊断内异症恶变具有较好的效能和一定的临床应用价值,有可能成为临床早期无创诊断子宫内膜异位症相关性卵巢癌的新方法。

Objective To analyze the differences of hematological indicators between endometriosis patients and endometriosis associated ovarian cancer patients,also to explore clinical indicators those have diagnostic value for the malignant transformation of endometriosis.Methods Compare the peripheral blood indexes(NEUT%,LYM%,MXD%,EO%,NEUT#,LYM#,MXD#,WBC,PLT,TBIL,DBIL,IBIL,ALB,CRP,CA125,HE4,NLR,MLR,PLR,ELR,CRP/ALB,SII,SIRI),between patients with endometriosis and patients with endometriosis associated ovarian cancer,and Logistic regression analysis was used to construct joint diagnostic indicators.Results WBC,NEUT%,NEUT#,CA125,HE4,NLR,SII,SIRI in patients with endometriosis associated ovarian cancer were higher than those in the endometriosis group(P<0.05),while LYM%and ALB were lower(P<0.05).After adjusting the influence of NEUT%,CA125,NLR,SII,SIRI,LYM%,WBC(P=0.023),NEUT#(P=0.014),HE4(P<0.001),ALB(P=0.045)were significantly related to the occurrence of malignant change,ROC curve showed that the AUC(0.831)of the combination of WBC、NEUT#and HE4 was greater than each individul index,and it had a higher sensitivity(81.10%).Conclusion The combination of WBC,NEUT#and HE4in the diagnosis of endometriosis malignant transformation has good efficiency and certain clinical application value,and may become a new method for non-invasive diagnosis of EAOC in the early stage.