卵巢癌患者血清CA125、D-二聚体、Apo E水平的变化及意义

Changes and Significance of Serum CA125,D-Dimer,and ApoE Levels in Ovarian Cancer Patients

目的:分析血清CA125、D-二聚体、ApoE在卵巢癌患者中的表达水平,并探讨其诊断价值,以期提高早期卵巢癌的确诊率。方法:通过回顾性分析2018年3月至2021年3月在上海中医药大学附属普陀医院妇科就诊的121例卵巢肿瘤患者的临床资料,其中术后病理组织学检查确诊为卵巢癌53例和卵巢良性肿瘤68例,分析其及同期本院体检中心50例健康志愿者血清中CA125、D-二聚体、ApoE的水平,制作ROC曲线,分别探讨CA125、D-二聚体、ApoE和三者联合在卵巢癌诊断中的价值。结果:卵巢癌组患者血清中CA125、D-二聚体、ApoE水平分别为380.61±401.94 U/L、2.22±2.56 mg/L、51.98±15.33mg/L,均高于卵巢良性肿瘤组和正常对照组,差异有统计学意义(P<0.05);卵巢良性肿瘤组CA125、D-二聚体、ApoE水平分别为50.85±70.99U/L,0.60±0.50 mg/L,43.82±26.93 mg/L,均高于正常对照组(均P<0.05);卵巢癌患者血清CA125、D-二聚体、ApoE水平随FIGO分期的增加而升高,差异均有统计学意义(均P<0.05);浆液性卵巢癌患者血清CA125、D-二聚体、ApoE水平高于非浆液性卵巢癌者,差异均有统计学意义(均P<0.05);ROC曲线显示CA125的曲线下面积(AUC)为0.805,D-二聚体的AUC为0.812,ApoE的AUC为0.709,三者联合诊断的AUC为0.835。结论:卵巢癌患者血清CA125、D-二聚体、ApoE均呈高表达,均较正常对照组升高,且随着FIGO分期增加而逐渐升高,对卵巢癌有辅助确诊意义,联合检测对卵巢癌的诊断价值高于各单项指标的检测,对卵巢癌的早期诊断、病情发展监测、预后评价具有更重要的意义。

Objective:To analyze the expression levels of serum CA125,D-dimer,and ApoE in ovarian cancer patients and explore their diagnostic value,in order to improve the diagnostic rate of early ovarian cancer.Methods:A retrospective analysis was conducted on the clinical data of 121 patients with ovarian tumors who visited the gynecology department of Putuo Hospital Affiliated to Shanghai University of Traditional Chinese Medicine from March 2018 to March 2021.Among them,53 patients were diagnosed with ovarian cancer and 68 patients with ovarian benign tumors through postoperative histopathological examination.The levels of CA125,D-dimer,and ApoE in the serum of 50 healthy volunteers from the same period's physical examination center were analyzed and ROC curve was made to investigate the value of CA125,D-dimer,ApoE and the combination of CA125,D-dimer and Apoe in the diagnosis of ovarian cancer.Results:The serum levels of CA125,D-dimer and ApoE in ovarian cancer group were 380.61±401.94U/L,2.22±2.56mg/L and 51.98±15.33mg/L,respectively,which were higher than those in benign ovarian tumor group and normal control group,and the difference was statistically significant(P<0.05).The levels of CA125,D-dimer and ApoE in benign ovarian tumor group were 50.85±70.99U/L,0.60±0.50mg/L and 43.82±26.93mg/L,respectively,which were higher than those in normal control group(all P<0.05).The serum levels of CA125,D-dimer and ApoE in ovarian cancer patients increased with the increase of FIGO stage,and the differences were statistically significant(all P<0.05).Serum levels of CA125,D-dimer and ApoE in serous ovarian cancer patients were higher than those in non-serous ovarian cancer patients,and the differences were statistically significant(all P<0.05).ROC curve showed that the area under curve(AUC)of CA125 was 0.805,the AUC of D-dimer was 0.812,the AUC of ApoE was 0.709,and the AUC of combined diagnosis of the three was 0.835.Conclusions:The serum CA125,D-dimer,and ApoE levels in ovarian cancer patients are highly expressed,which are higher than those in the normal control group.They gradually increase with the increase of FIGO staging,and have auxiliary diagnostic significance for ovarian cancer.Combined testing has higher diagnostic value for ovarian cancer than the detection of various individual indicators,and has more important significance for early diagnosis,disease development monitoring,and prognosis evaluation of ovarian cancer.