CA125、HE4和mSEPT9对子宫内膜癌临床诊断价值的研究

Comparison of the clinical diagnostic value of CA125,HE4 and mSEPT9 in endometrial cancer

目的评估血清中人附睾蛋白4(HE4)、糖类抗原125(CA125)、尿液中SEPT9基因甲基化(mSEPT9)水平在诊断子宫内膜癌的临床价值。方法选取2021年11月—2022年5月于徐州医科大学附属医院确诊为子宫内膜癌的患者40例作为研究组。选取同期子宫内膜良性病变患者39例作为对照组。采用化学发光法检测2组患者血清CA125、HE4水平。采用实时荧光定量PCR法检测2组患者尿液mSEPT9 Ct值。结果研究组血清CA125、HE4水平显著高于对照组(P<0.05)。根据ROC曲线,将血清CA125、HE4和尿液mSEPT9 Ct值的截断值分别设为14.65 kU/L,52.44 pmol/L,38.95。研究组CA125、HE4、mSEPT9阳性率显著高于对照组,差异有统计学意义(P<0.05)。CA125、HE4、mSEPT9的曲线下面积均>0.5,具有临床诊断意义,mSEPT9单项检测特异度明显高于HE4及CA125。CA125水平与病理分期、病理分级、淋巴脉管转移相关(P<0.05);HE4水平与年龄、肌层浸润深度相关(P<0.05);mSEPT9阳性率与手术病理分期、肌层浸润深度、淋巴及脉管转移相关(P<0.05)。结论尿液mSEPT9检测在子宫内膜癌筛查中具有较大潜力,为子宫内膜癌筛查提供新的思路。

Objective To evaluate serum human epididymal protein 4(HE4),carbohydrate antigen 125(CA125)and methylation of SEPT9(mSEPT9)in the urine in the diagnosis of endometrial cancer.Methods A total of 40 patients who were admitted to the Affiliated Hospital of Xuzhou Medical University and diagnosed with endometrial cancer were selected as a research group.Meanwhile,39 patients who were diagnosed with benign endometrial lesions were selected as a control group.Their levels of serum HE4 and CA125 were detected by chemiluminescence.Their Ct values of mSEPT9 in the urine were detected by real-time fluorescent quantitative PCR.Results The research group showed remarkably higher levels of serum CA125 and HE4 than the control group(P<0.05).According to ROC curves,the cut-off values of serum CA125,HE4 and urine mSEPT9 Ct values were 14.65 kU/L,52.44 pmol/L and 38.95,respectively.The research group presented significantly higher detection rates of serum CA125 and HE4 and urine mSEPT9 than the control group(P<0.05).According to ROC curves,the area under the curve of mSEPT9,CA125 and HE4 were all>0.5,with clinical diagnostic significance.The specificity of mSEPT9 was higher than those of HE4 and CA125.Furthermore,CA125 level was correlated with pathological stage,pathological grade and lymphatic vascular metastasis(P<0.05);HE4 level was correlated with age and depth of muscle infiltration(P<0.05);and the positive rate of mSEPT9 was correlated with pathological stage,depth of muscle infiltration,lymphatic and vascular metastasis(P<0.05).Conclusions Detection of urine mSEPT9 has great potential in the screening of endometrial cancer,prociding new thoughts for endometrial cancer screening.