血清CEA、AFP、CA199、CA125、SCC联合检测在宫颈恶性病变诊断中的价值

Value of Combined Detection of Serum CEA,AFP,CA199,CA125 and SCC in the Diagnosis of Malignant Cervical Lesions

目的 探讨血清癌胚抗原(CEA)、甲胎蛋白(AFP)、糖类抗原199(CA199)、糖类抗原125(CA125)、鳞状上皮细胞癌抗原(SCC)联合检测在宫颈恶性病变诊断中的价值。方法 选取2020年1月至2022年12月黄河科技学院附属医院收治的116例宫颈病变患者,其中64例宫颈癌患者作为癌变组,52例宫颈癌前病变患者为癌前病变组,另选取体检健康的41例女性作为对照组,采用化学发光法检测血清CEA、AFP、CA199、CA125、SCC水平,以受试者工作特征(ROC)曲线评估CEA、AFP、CA199、CA125、SCC对宫颈恶性病变的诊断效能。结果 血清CEA、AFP、CA199、CA125、SCC水平随宫颈病变程度增加呈上升趋势;癌变组血清CEA、AFP、CA199、CA125、SCC水平高于癌前病变组和对照组(P<0.05);ROC曲线分析结果显示,单项检测以SCC诊断效能最佳,曲线下面积为0.819,截断值为2.252μg·L^(-1),敏感度为73.44%,特异度为94.26%(P<0.05),联合检测曲线下面积为0.915,高于单项检测。结论 血清SCC水平单项诊断宫颈恶性病变效能优于CEA、AFP、CA199、CA125,5种肿瘤标志物联合诊断效能更佳。

Objective To investigate the value of combined detection of serum carcinoembryonic antigen(CEA),alpha-fetoprotein(AFP),carbohydrate antigen 199(CA199),carbohydrate antigen 125(CA125)and squamous cell carcinoma antigen(SCC)in the diagnosis of malignant cervical lesions.Methods A total of 116 patients with cervical lesions who admitted to the Huanghe Science and Technology Affiliated Hospital from January 2020 and December 2022 were selected,including 64 patients with cervical cancer(cancer group)and 52 patients with cervical precancerous lesions(precancerous lesion group).Meanwhile,41 healthy females were selected as the control group.The chemiluminescence method was used to detect serum CEA,AFP,CA199,CA125 and SCC levels.The receiver operating characteristic(ROC)curve was used to evaluate the diagnostic performance of CEA,AFP,CA199,CA125 and SCC for malignant cervical lesions.Results The levels of serum CEA,AFP,CA199,CA125 and SCC showed an upward trend with the aggravation of cervical lesions.The levels of serum CEA,AFP,CA199,CA125 and SCC in the cancer group were higher than those in the precancerous lesion group and the control group(P<0.05).ROC curve analysis showed that for single item detection,the diagnostic efficiency of SCC was the highest,and the area under the curve,cut-off value,sensitivity and specificity were 0.819,2.252μg·L^(-1),73.44%and 94.26%,respectively(P<0.05).The area under the curve of combined detection was 0.915,which was higher than that of single detection.Conclusion Serum SCC level has better performance than CEA,AFP,CA199 or CA125 in the diagnosis of malignant cervical lesions.The combined detection of the 5 tumor markers is more effective.