肿瘤标志物在不同妇科肿瘤中的差异分析

Analysis of the difference of gynecological tumor markers in different tumors

目的分析10种肿瘤标志物在妇科肿瘤患者中的差异及相关性。方法采集卵巢癌、宫颈癌、子宫内膜癌、乳腺癌患者血液样本,采用化学发光法检测糖类抗原125(CA125)、癌胚抗原(CEA)、CA153、CA50、铁蛋白(FRT)、人附睾蛋白4(HE4)、鳞状细胞癌抗原(SCC)、β人绒毛膜促性腺激素(β-HCG)水平,运用卵巢恶性肿瘤风险算法计算绝经后罗马指数(post-ROMA)、绝经前罗马指数(pre-ROMA)的结果。比较分析上述标志物在4种妇科肿瘤患者中的阳性率及水平差异,采用Spearman分析肿瘤标志物之间的相关性。结果卵巢癌患者年龄高于乳腺癌患者,其余各组患者年龄分布差异无统计学意义(P>0.05)。不同肿瘤标志物在妇科肿瘤中的阳性率结果显示:CA125、HE4、SCC及post-ROMA在4种肿瘤患者中的阳性率差异有统计学意义(P<0.05),其他肿瘤标志物在4种肿瘤患者中的阳性率差异无统计学意义(P>0.05)。CA125、HE4及post-ROMA在卵巢癌患者中阳性率最高,SCC在宫颈癌患者中阳性率最高。10种肿瘤标志物在妇科肿瘤中的水平结果显示:CA125、FRT、HE4、post-ROMA、pre-ROMA在卵巢癌患者中的水平显著高于其他肿瘤患者,差异有统计学意义(P<0.05);CA153在卵巢癌患者中的水平显著高于宫颈癌和子宫内膜癌,差异有统计学意义(P<0.05);SCC在宫颈癌患者中的水平显著高于其他患者,差异有统计学意义(P<0.05);β-HCG在乳腺癌患者中的水平低于卵巢癌和宫颈癌患者,其他患者组之间差异无统计学意义(P>0.05)。妇科肿瘤中10种肿瘤标志物之间的相关性分析结果显示:在卵巢癌患者中,CA125与CA153、HE4、post-ROMA、pre-ROMA的相关系数分别为0.63、0.80、0.95及0.80;HE4与post-ROMA、pre-ROMA的相关系数分别为0.92、1.00,post-ROMA与pre-ROMA相关系数为0.92。在宫颈癌患者中,CA125与post-ROMA相关系数为0.86;HE4与post-ROMA、pre-ROMA的相关系数分别为0.65、1.00,post-ROMA与pre-ROMA相关系数为0.70。在子宫内膜癌患者中,CA125与post-ROMA相关系数为0.67,CA50与HE4、post-ROMA相关系数分别为0.60和0.61,HE4与post-ROMA、pre-ROMA、β-HCG的相关系数分别为0.75、1.00、0.70,post-ROMA、pre-ROMA相关系数为0.75,pre-ROMA与β-HCG相关系数为0.69。在乳腺癌患者中,CA125与post-ROMA相关系数为0.87,HE4与post-ROMA、pre-ROMA相关系数分别为0.78、1.00,post-ROMA与pre-ROMA相关系数为0.81。结论不同肿瘤标志物在妇科肿瘤中的阳性率和水平存在显著差异,而且不同类型肿瘤标志物在肿瘤中具有显著的相关性。

Objective To analyze the difference and correlation of 10 tumor markers in gynecological tumor patients.Methods Collected blood samples from patients with ovarian,cervical,endometrial and breast cancer,The levels of carbohydrate antigen 125(CA125),carcinoembryonic antigen(CEA),CA153,CA50,ferritin(FRT),human epididymal protein 4(HE4),squamous cell carcinoma antigen(SCC)andβ-human chorionic gonadotropin(β-HCG)were detected by chemiluminescence.Results of the post-ROMA and pre-ROMA indices were calculated using the ovarian malignancy risk algorithm.Spearman analysis was used to analyze the correlation among tumor markers through comparative analysis of the difference in the positive rate and level of the above markers in gynecological tumor patients.Results The age of ovarian cancer patients was higher than that of breast cancer patients,and there was no statistical difference in the age distribution of other groups.The positive rates of different tumor markers in gynecological tumors showed statistically significant differences in the positive rates of CA125,HE4,SCC and post-ROMA among the Patients with 4 types of tumors,the differences were statistically significant(P<0.05),there was no statistical difference in the positive rates of other tumor markers among the Patients with 4 types of tumors,the difference was no statistically significant(P>0.05).CA125,HE4 and post-ROMA have the highest positive rates in ovarian cancer.SCC has the highest positive rate in patients with cervical cancer.Levels of CA125,FRT,HE4,post-ROMA,and pre-ROMA in ovarian cancer were significantly higher than those in other cancers.The level of CA153 in ovarian cancer was significantly higher than that in cervical cancer and endometrial cancer,the differences were statistically significant(P<0.05).The level of SCC in cervical cancer patients was significantly higher than that in other patients,the differences were statistically significant(P<0.05).Levels ofβ-HCG were lower in breast cancer patients than in ovarian and cervical cancer patients,the difference was statistically significant(P<0.05),and the differences between the other patient groups was no statistically significant(P>0.05).In ovarian cancer,the correlation coefficients between CA125 and CA153,HE4,post-ROMA,and pre-ROMA were 0.63,0.80,0.95 and 0.80,respectively.The correlation coefficients for HE4 with post-ROMA and pre-ROMA were 0.92 and 1.00,respectively.The correlation coefficient between post-ROMA and pre-ROMA is 0.92.In patients with cervical cancer,the correlation coefficient between CA125 and post-ROMA is 0.86.The correlation coefficients for HE4 with post-ROMA and pre-ROMA were 0.65 and 1.00,respectively.Post-ROMA and pre-ROMA have a correlation coefficient of 0.70.In patients with endometrial cancer,the correlation coefficient between CA125 and post-ROMA is 0.67.CA50 is 0.60 for HE4 and 0.61 for Post-ROMA.The correlation coefficients of HE4 with post-ROMA,pre-ROMA,andβ-HCG are 0.75,1.00 and 0.70,respectively.The correlation coefficient for post-ROMA and pre-ROMA is 0.75;The correlation coefficient between pre-ROMA andβ-hCG is 0.69.In breast cancer,CA125 is 0.87 post-ROMA;The correlation coefficients for HE4 with post-ROMA and pre-ROMA were 0.78 and 1.0,respectively.The post-ROMA and pre-ROMA correlation coefficient is 0.81.Conclusion There are significant differences in the positive rates and levels of different tumor markers in gynecological tumors,and different types of tumor markers have significant correlations in tumors.