血清HMGB1和SAA对宫颈癌术后发生预后不良的诊断价值

Diagnostic value of serum HMGB1 and SAA in postoperative poor prognosis of cervical cancer

目的 观察血清高迁移率族蛋白B1(HMGB1)和血清淀粉样蛋白A(SAA)对宫颈癌术后发生预后不良的诊断价值。方法 选择2015年1月至2019年12月在该院行宫颈癌根治术的患者98例为宫颈癌组,选择同期在该院体检的健康者45例为健康对照组。观察宫颈癌组和健康对照组血清HMGB1和SAA变化;进行宫颈癌患者术后血清HMGB1和SAA水平与术前的比较;分析宫颈癌患者术后预后不良的影响因素;分析血清HMGB1和SAA水平对宫颈癌术后预后不良的诊断效能,以及血清HMGB1和SAA之间的相关性。结果 宫颈癌组术前血清SAA、HMGB1和CA125水平均明显高于健康对照组(P<0.01);宫颈癌组术后7 d血清SAA、HMGB1和CA125水平均较术前明显降低(P<0.01)。宫颈癌预后不良组的肿瘤最大径比例、肿瘤分化程度比例、淋巴结转移比例以及血清SAA、HMGB1、CA125水平与预后良好组相比,差异均有统计学意义(P<0.05)。多因素分析发现血清HMGB1>22.76 pg/μL和SAA>79.35 mg/L是宫颈癌患者术后预后不良的危险因素(P<0.05)。血清HMGB1和SAA水平对宫颈癌患者术后发生预后不良的诊断效能明显高于CA125(P<0.05);HMGB1和SAA联合检测判断宫颈癌患者术后发生预后不良的灵敏度为92.6%,特异度为93.0%,曲线下面积(AUC)为0.975,AUC明显高于HMGB1(Z=2.463,P<0.05)、SAA(Z=2.559,P<0.05)单项检测。宫颈癌患者血清HMGB1水平与SAA呈正相关(r=0.642,P<0.01)。结论 血清HMGB1和SAA水平对判断于宫颈癌术后预后不良有一定的参考价值。

Objective To observe the diagnostic value of serum high mobility group box B1(HMGB1) and serum amyloid A(SAA) in the poor prognosis occurrence after cervical cancer surgery.Methods Ninety-eight patients with cervical cancer radical operation in this hospital from January 2019 to December 2021 were selected as the cervical cancer group.Contemporaneous 45 subjects undergoing physical examination in this hospital were selected as the healthy control group.The changes of serum HMGB1 and SAA in the cervical cancer group and healthy control group were observed;the levels of serum HMGB1 and SAA were compared between before and after cervical cancer surgery;the influencing factors of poor prognosis after operation in the patients with cervical cancer were analyzed;the diagnostic efficiency of serum HMGB1 and SAA levels for poor prognosis after cervical cancer operation and the correlation between serum HMGB1 and SAA were analyzed.Results The serum SAA,HMGB1 and CA125 levels in the cervical cancer group were significantly higher than those in the healthy control group(P<0.01),and the levels of serum SAA,HMGB1 and CA125 on postoperative 7 d in the cervical cancer group were significantly decreased compared with those before operation(P<0.01).The proportion of the largest diameter of tumor,proportion of tumor differentiation,proportion of lymph node metastasis,and levels of serum SAA,HMBG1,CA125 in the cervical cancer poor prognosis group were significantly different from those in the good prognosis group(P<0.05).The multifactor analysis found that serum HMGB1>22.76 pg/μL and SAA>79.35 mg/L were the risk factors for postoperative poor prognosis in the patients with cervical cancer(P<0.05).The diagnostic efficiency of serum HMGB1 and SAA levels for the poor prognosis occurrence in the patients with cervical cancer was significantly higher than that of CA125(P<0.05);the sensitivity,specificity and area under the curve(AUC) of the combined detection of HMGB1 and SAA for judging the postoperative poor prognosis occurrence were 92.6%,93.0% and 0.975 respectively.AUC was significantly higher than that of HMGB1(Z=2.463,P<0.05) and SAA(Z=2.559,P<0.05) single detection.The serum HMGB1 level in the patients with cervical cancer was positively correlated with SAA(r=0.642,P<0.01).Conclusion The serum HMGB1 and SAA levels have certain reference value for judging the postoperative poor prognosis of cervical cancer.