血清鳞状上皮细胞癌抗原、糖类抗原125水平在宫颈癌盆腔淋巴结转移中的预测价值

Predictive value of serum squamous cell carcinoma antigen and carbohydrate antigen 125 in pelvic lymph node metastasis of cervical cancer

目的 探讨血清鳞状上皮细胞癌抗原(SCCA)与糖类抗原125(CA125)对宫颈癌盆腔淋巴结转移(LNM)的预测价值。方法 选取2017年1月至2022年12月蒙城县第一人民医院诊治的81例宫颈癌患者作为研究对象。根据手术病理结果是否伴有盆腔淋巴结转移分为有淋巴结转移组(LNM组,n=27)和无淋巴结转移组(NLNM组,n=54);收集两组的临床资料,术前采集外周静脉血并检测血清SCCA和CA125水平;采用多因素Logsitic回归模型分析盆腔LNM的独立危险因素;采用受试者工作特征(ROC)曲线评价术前血清SCCA和CA125对盆腔LNM的预测价值。结果 两组间质浸润深度、脉管浸润情况及术前血清SCCA、CA125水平比较,差异具有统计学意义(P<0.05);两组年龄、国际妇产科联盟(FIGO)分期、病理分级比较,差异无统计学意义(P>0.05)。多因素Logistic回归模型分析结果显示,间质浸润深度≥1/2、术前高SCCA和CA125水平是宫颈癌合并盆腔LNM的独立危险因素(P<0.05)。ROC曲线分析结果显示,SCCA、CA125联合预测盆腔LNM的曲线下面积(AUC)为0.849(95%CI:0.778~0.904),大于SCCA或CA125单独预测的AUC[0.781(95%CI:0.702~0.847)、0.731(95%CI:0.649~0.803)](P<0.05)。结论 宫颈癌患者术前血清SCCA和CA125水平异常升高与盆腔LNM密切相关,两者联合预测宫颈癌LNM的应用价值较高。

Objective To explore the predictive value of serum squamous cell carcinoma antigen(SCCA)and carbohydrate antigen 125(CA125)in pelvic lymph node metastasis(LNM)of cervical cancer.Methods A total of 81 patients with cervical cancer in Mengcheng County First People′s Hospital were enrolled as research subjects between January 2017 and December 2022.According to presence or absence of pelvic LNM,they were divided into LNM group(n=27)and non-LNM group(NLNM group,n=54).The clinical data in the two groups were collected.The peripheral venous blood was collected before surgery to detect levels of serum SCCA and CA125.The independent risk factors of pelvic LNM were analyzed by multivariate Logistic regression model.The predictive value of preoperative serum SCCA and CA125 for pelvic LNM was evaluated by receiver operating characteristic(ROC)curves.Results There were significant differences in the depth of interstitial infiltration,vascular infiltration and preoperative levels of serum SCCA and CA125 between LNM group and NLNM group(P<0.05),but there was no significant difference in age,international federation of gynecology and obstetrics(FIGO)staging or pathological grading(P>0.05).Multivariate Logistic regression model analysis showed that interstitial infiltration depth≥1/2 and preoperative high levels of SCCA and CA125 were independent risk factors of pelvic LNM(P<0.05).The results of ROC curve analysis showed that area under ROC curve(AUC)of SCCA combined with CA125 for predicting pelvic LNM was 0.849(95%CI:0.778-0.904),greater than that of single index[0.781(95%CI:0.702-0.847),0.731(95%CI:0.649-0.803)](P<0.05).Conclusions The abnormal increase of serum SCCA and CA125 before surgery is closely related to pelvic LNM in patients with cervical cancer.The predictive value of SCCA combined with CA125 is high for pelvic LNM.