糖类抗原125、人附睾蛋白4、miRNA-144-3p对卵巢癌患者化疗疗效的预测价值及影响因素分析

Predictive value and influencing factors of carbohydrate antigen 125,human epididymis protein 4,and miRNA-144-3p in the efficacy of chemotherapy in ovarian cancer patients

目的 探讨糖类抗原125(CA125)、人附睾蛋白4(HE4)、miRNA-144-3p对卵巢癌患者化疗疗效的预测价值及影响因素。方法 选取60例卵巢癌患者,术后给予化疗,根据化疗效果将其分为有效组和无效组,比较两组患者的CA125、HE4、miRNA-144-3p水平。卵巢癌患者化疗疗效的影响因素采用多因素Logistic回归分析;绘制受试者工作特征(ROC)曲线,计算曲线下面积(AUC),评估CA125、HE4、miRNA-144-3p单独及联合检测对卵巢癌患者化疗疗效的预测价值。结果 化疗后,治疗有效39例,治疗无效21例,分别作为有效组和无效组。化疗前,有效组患者血清CA125、HE4水平均明显低于无效组,miRNA-144-3p水平明显高于无效组,差异均有统计学意义(P﹤0.01)。多因素Logistic回归分析结果显示,化疗前CA125水平≥35 U/ml、化疗前HE4水平≥140 pmol/L、化疗前miRNA-144-3p水平﹤3、肿瘤直径﹥5 cm均是卵巢癌患者化疗疗效的独立危险因素(P﹤0.05)。ROC曲线显示,血清化疗前CA125、HE4、miRNA-144-3p联合检测预测卵巢癌患者化疗疗效的AUC为0.965(95%CI:0.924~0.999),此时的灵敏度为89.74%,特异度为95.24%,准确度为91.67%。结论化疗前CA125、HE4、miRNA-144-3p联合检测卵巢癌患者化疗疗效具有较高的预测价值,较低的化疗前CA125、HE4水平和较高的miRNA-144-3p水平提示卵巢癌患者的化疗疗效较好。

Objective To investigate the predictive value and influencing factors of carbohydrate antigen 125(CA125),human epididymis protein 4(HE4),and miRNA-144-3p in the efficacy of chemotherapy in ovarian cancer patients.Method Sixty patients with ovarian cancer were selected and given chemotherapy after surgery.They were divided into effective group and ineffective group based on the chemotherapy effect,the levels of CA125,HE4,and miRNA-144-3p were compared between the two groups.The influencing factors of chemotherapy efficacy in ovarian cancer patients were analyzed using multivariate Logistic regression analysis.Draw the receiver operating characteristic(ROC)curve and calculate the area under the curve(AUC)to evaluate the predictive value of CA125,HE4,and miRNA-144-3p alone and in combination for the efficacy of chemotherapy in ovarian cancer patients.Result After chemotherapy,39 cases were treated effectively and 21 cases were treated inefficiently,serving as the effective group and ineffective group,respectively.Before chemotherapy,the serum levels of CA125 and HE4 in the effective group were lower than those in the ineffective group,and the level of miRNA-144-3p was higher than that in the ineffective group,the differences were statistically significant(P<0.01).Multivariate Logistic regression analysis showed that pre-chemotherapy CA125 level≥35 U/ml,pre-chemotherapy HE4 level≥140 pmol/L,pre-chemotherapy miRNA-144-3p level<3,and lesion diameter>5 cm were all independent risk factors for chemotherapy efficacy in ovarian cancer patients(P<0.05).The AUC of combined detection of pre-chemotherapy serum CA125,HE4,miRNA-144-3p to predict the efficacy of chemotherapy in ovarian cancer patients was 0.965(95%CI:0.924-0.999),at this time,the sensitivity was 89.74%,the specificity was 95.24%,and the accuracy was 91.67%(P<0.05).Conclusion The combined detection of CA125,HE4,and miRNA-144-3p before chemotherapy has high predictive value for the efficacy of chemotherapy in ovarian cancer patients.Lower levels of CA125,HE4 before chemotherapy and higher level of miRNA-144-3p suggest better efficacy of chemotherapy in ovarian cancer patients.