卵巢癌血清SDF-1、肿瘤标志物变化及联合检测诊断卵巢癌价值分析

Analysis of the value of serum SDF-1,tumor markers and combined detection in the diagnosis of ovarian cancer

目的 探究血清基质细胞衍生因子-1(SDF-1)、肿瘤标志物[癌抗原125(CA125)、人附睾蛋白4(HE4)、糖类抗原199(CA199)]水平变化,并分析上述指标联合诊断卵巢癌的价值.方法 选取2021年3月-2023年7月在贵州金域医学检验中心经病理检查确诊的卵巢肿瘤患者102例,其中良性肿瘤62例,卵巢癌40例.比较两组患者的临床资料及SDF-1、CA125、HE4、CA199水平差异,采用Logistic回归分析筛选卵巢癌的危险因素,通过绘制ROC曲线分析相关指标单一及联合诊断卵巢癌的价值.依据病理分期将卵巢癌患者划分为Ⅰ-Ⅱ期和Ⅲ-Ⅳ期两个亚组,分析不同分期与SDF-1、CA125、HE4、CA199水平的关系.结果 卵巢癌组患者SDF-1、CA125、HE4、CA199水平均高于良性肿瘤组(P<0.05).SDF-1、CA125、HE4、CA199为卵巢癌发生的危险因素(P<0.05).当SDF-1、CA125、HE4、CA199分别为4372.76pg/mL、118.15U/mL、247.00pmol/L、67.37U/mL时,其诊断卵巢癌的AUC分别为0.814、0.794、0.824、0.805(P<0.05).SDF-1、CA125、HE4、CA199联合诊断卵巢癌的AUC为0.978,敏感度与特异度分别为95.12%和90.16%,联合诊断效能均较SDF-1、CA125、HE4、CA199单一指标更高(Z=3.514、3.562、3.850、4.190,P<0.05).卵巢癌Ⅲ-Ⅳ期患者SDF-1、CA125、HE4、CA199水平高于Ⅰ-Ⅱ期(P<0.05),且SDF-1、CA125、HE4、CA199分别与卵巢癌分期呈正相关(r=0.518、0.456、0.419、0.527,P<0.05).结论 卵巢癌患者其SDF-1、CA125、HE4、CA199等肿瘤标志物水平表达异常升高,联合检测有助于提高临床卵巢癌的诊断准确率.

Objective To investigate the changes in serum levels of stromal cell derived factor-1(SDF-1),tumor markers[cancer antigen 125(CA125),human epididymal protein 4(HE4),and carbohydrate antigen 199(CA199)],and to analyze the diagnostic value of combined detection of SDF-1,CA125,HE4,and CA199 in ovarian cancer.Method 102 patients with ovarian tumors who were diagnosed through pathological examination in the medical laboratory center from March 2021 to July 2023 were selected,including 62 cases of benign tumors and 40 cases of ovarian cancer.Compare the clinical data and differences in SDF-1,CA125,HE4,and CA199 levels between two groups of patients,use logistic regression analysis to screen for risk factors for ovarian cancer,and analyze the value of single and combined diagnostic indicators for ovarian cancer by drawing ROC curves.Ovarian cancer patients were divided into two subgroups,stage Ⅰ-Ⅱ and stage Ⅲ-Ⅳ,based on pathological staging.The relationship between different stages and levels of SDF-1,CA125,HE4 and CA199 was analyzed.Results The levels of SDF-1,CA125,HE4 and CA199 in the ovarian cancer group were higher than those in the benign tumor group(P<0.05).SDF-1,CA125,HE4,and CA199 are risk factors for ovarian cancer(P<0.05).The AUC of SDF-1,CA125,HE4 and CA199 combined diagnosis for ovarian cancer was 0.978,with sensitivity and specificity of 95.12%and 90.16%,respectively.When SDF-1,CA125,HE4,and CA199 were 4372.76pg/mL,118.15U/mL,247.00pmol/L,and 67.37U/mL,respectively,their AUC for diagnosing ovarian cancer was 0.814,0.794,0.824,and 0.805(P<0.05).The combined diagnostic efficacy was higher than SDF-1,CA125,HE4 and CA199 single indicators(Z-3.514,3.562,3.850,4.190,P<0.05).The levels of SDF-1,CA125,HE4 and CA199 in patients with ovarian cancer stage Ⅲ-Ⅳ were higher than those in stage Ⅰ-Ⅱ(P<0.05),and SDF-1,CA125,HE4,CA199 were positively correlated with ovarian cancer stage(r-0.518,0.456,0.419,0.527,P<0.05).Conclus ion Ovarian cancer patients have abnormally elevated levels of tumor markers such as SDF-1 and CA125,HE4,CA199.Combined detection can help improve the diagnostic accuracy of clinical ovarian cancer.