卵巢癌患者肿瘤标志物和纤溶指标水平变化及其诊断价值分析

Changes of Tumor Markers and Fibrinolytic Indexes in Ovarian Cancer Patients and Their Diagnostic Value

目的:探讨卵巢癌患者纤溶指标水平和糖类抗原125(CA125)/人附睾蛋白4 (HE4)水平变化及临床意义。方法:收集2021-2022年在本院妇产科就诊并病理检查确诊的妇科肿瘤患者100例,其中卵巢癌50例(卵巢癌组),妇科良性肿瘤50例(对照组)。采用全自动凝血分析仪检测纤维蛋白原(FIB)水平,用免疫比浊法测定纤维蛋白降解产物(FDP)和D-二聚体(D-D)含量,采用电化学发光法检测CA125和HE4水平,采用Logistic回归筛选卵巢癌的危险因素,通过受试者工作特征曲线(ROC)分析相关指标对卵巢癌的诊断价值。结果:卵巢癌组血浆FIB、FDP、D-D以及血清CA125和HE4水平均显著高于对照组(均P<0.01);多因素分析结果显示,FIB (OR=2.375)和CA125 (OR=1.060)为卵巢患者的危险因素(P<0.01);ROC曲线分析显示,FIB、CA125以及二者联合检测(联合模型)诊断卵巢癌的ROC曲线下面积(AUC)分别为0.831、0.957和0.962(均P<0.01),其中联合模型的AUC最大,诊断价值最高。结论:FIB和CA125为卵巢患者的危险因素;联合模型对卵巢癌患者具有更优诊断价值。

Objective:To investigate the changes and clinical significance of fibrinolytic markers and carbohydrate antigen 125(CA125)and human epididymal protein 4(HE4)levels in ovarian cancer patients.Method:A total of 100 gynecological tumor patients confirmed by pathological examination from 2021 to 2022 were collected,including 50 cases of ovarian cancer(ovarian cancer group)and 50 cases of gynecological benign tumors(control group).Fibrinogen(FIB)levels were detected by automatic coagulation analyzer.The contents of fibrin degradation product(FDP)and D-dimer(D-D)were measured by immunoturbidimetric method.The levels of CA125 and HE4 were detected by electrochemiluminescence.The risk factors of ovarian cancer were screened by logistic regression.The diagnostic value of relevant indicators in ovarian cancer was analyzed by receiver operating curve(ROC).Results:The levels of serum FIB,FDP,D-D,CA125 and HE4 in ovarian cancer group were significantly higher than those in control group(all P<0.01),and logistic regression analysis showed that FIB(OR=2.375)and CA125(OR=1.060)were risk factors for prognosis of ovarian patients(P<0.01).ROC curve analysis showed that the area under the curve(AUC)of FIB,CA125 and the combined model were 0.831,0.957,0.962(all P<0.01),respectively.The AUC of the combined model was the largest,which was of high diagnostic value.Conclusion:FIB and CA125 are risk factors for the prognosis of ovarian patients and combined model of CA125 and FIB have high diagnostic value in ovarian cancer patients.