hTERT、CA125、HE4联合XPO4检测在子宫内膜癌诊断及预后评估中的临床意义

The Clinical Significance of hTERT,CA125,HE4 Combined withXPO4 in the Diagnosis and Prognosis Evaluation ofEndometrial Cancer

目的 探讨端粒酶逆转录酶(hTERT)、输出蛋白4(XPO4)、糖类抗原125(CA125)联合附睾蛋白4(HE4)检测在子宫内膜癌诊断及预后评估中的临床意义。方法 纳入2016年5月至2017年10月我院接受手术治疗的80例子宫内膜癌(恶性组)及80例子宫内膜增生患者(良性组),采集两组患者病灶样本及血清样本,检测两组hTERT、CA125、HE4、XPO4表达;并对患者随访3.6~5.3(4.5±0.6)年,根据预后差异分为预后良好组、预后不良组,对比两组hTERT、CA125、HE4、XPO4水平并绘制受试者工作特征(ROC)曲线,分析以上指标对疾病预后的预测价值。结果 恶性组hTERT mRNA、CA125、HE4表达高于良性组,XPO4 mRNA表达低于良性组(P<0.05)。预后不良组hTERT mRNA、CA125、HE4表达高于预后良好组,XPO4 mRNA表达低于预后良好组(P<0.05)。经ROC曲线分析,联合指标(hTERT mRNA、CA125、HE4、XPO4 mRNA)诊断子宫内膜癌及预测子宫内膜癌预后的效能的AUC、灵敏度、特异性更高。结论hTERT mRNA、CA125、HE4、XPO4 mRNA联合诊断子宫内膜癌及预测疾病预后有一定优势,可在临床中加以推广,便于为疾病诊疗提供参考。

Objective To explore the clinical significance of telomerase reverse transcriptase(hTERT),output protein 4(XPO4),carbohydrate antigen 125(CA125)and epididymal protein 4(HE4)in the diagnosis and prognosis of endometrial carcinoma.Methods For the current study,we included 80 patients with endometrial cancer(malignant group)and endometrial hyperplasia(benign group)who underwent surgical treatment in our hospital from May,2016 to October,2017.We collected lesion and serum samples from both groups of patients,and detected expressions of hTERT,CA125,HE4 combined with XPO4;And these patients were followed up for 3.6-5.3(4.5±0.6)years,and were divided into a good prognosis group and a poor prognosis group based on the difference in prognosis.Levels of hTERT,CA125,HE4 combined with XPO4 were compared between the two groups,and the receiver operating characteristic(ROC)curve was drawn to analyze the predictive value of the above indicators for disease prognosis.Results Expressions of hTERT mRNA,CA125,and HE4 in the malignant group were higher than that in the benign group,while the relative expression of XPO4 mRNA was lower than that in the benign group(P<0.05).Expressions of hTERT mRNA,CA125,and HE4 in the poor prognosis group were higher than that in the good prognosis group,while the relative expression of XPO4 mRNA was lower than that in the good prognosis group(P<0.05).According to receiver operating characteristic analysis,the AUC,sensitivity and specificity of combined indicators(hTERT mRNA,CA125,HE4 and XPO4 mRNA)in diagnosing endometrial cancer and predicting the prognosis of endometrial cancer were relatively higher.Conclusion The combination of hTERT mRNA,CA125,HE4,and XPO4 mRNA has certain advantages in diagnosing endometrial cancer and predicting disease prognosis,which can be promoted in clinical practice and provide reference for disease diagnosis and treatment.