禾蔻安双基因甲基化检测在子宫内膜癌筛查中的应用价值

Clinical value of CISENDO CDO1/CELF4 dual gene methylation detection in endometrial cancer screening for females with abnormal uterine bleeding

目的探讨禾蔻安双基因(CDO1和CELF4)甲基化检测在异常子宫出血患者中子宫内膜癌筛查的应用价值。方法选取2021年7月—2022年6月因异常子宫出血就诊于甘肃省妇幼保健院宫腔镜门诊的患者216例,收集宫颈脱落细胞进行双基因甲基化检测,同时收集患者基本信息、肿瘤生物学标记物与子宫内膜厚度等。以宫腔镜下子宫内膜组织病理学诊断为金标准,分析禾蔻安双基因甲基化检测对异常子宫出血女性中子宫内膜癌检出的敏感性与特异性。结果单因素分析中,年龄(P=0.001)、体重指数(BMI,P=0.002)、糖尿病(P=0.012)、绝经(P<0.001)、CDO1和CELF4甲基化(均P<0.001)对判断是否罹患子宫内膜癌的差异有统计学意义。二元Logistic回归分析结果显示,BMI的比值比(OR)为3.970(95%CI:[1.058,14.895],P=0.041),绝经的OR为18.702(95%CI:[1.847,189.370],P=0.013),CDO1、CELF4甲基化的OR分别为22.351(95%CI:[2.250,221.989],P=0.008)、60.995(95%CI:[5.992,620.920],P=0.001)。CDO1和CELF4甲基化检测敏感性为91.2%(95%CI:[76.3%,98.1%])、特异性为96.7%(95%CI:[93.0%,98.8%]);超声检查的敏感性、特异性分别为55.9%(95%CI:[37.9%,72.8%])和78.6%(95%CI:[71.9%,84.3%])。血清癌胚抗原125检查的敏感性、特异性分别为32.4%(95%CI:[17.4%,50.5%])和76.4%(95%CI:[69.0%,82.8%])。结论对于绝经后女性,禾蔻安双基因甲基化检测较目前妇科检查中的血清癌胚抗原125与超声检查具有更高的敏感性与特异性,可提示子宫内膜癌高风险。

Objective To explore the application value of CISENDO dual gene methylation detection(CDO1 and CELF4)in endometrial cancer screening in women with abnormal uterine bleeding.Methods A total of 216 patients who presented with abnormal uterine bleeding at the Gansu Provincial Maternal and Child-careHospital's hysteroscopy outpatient clinic between July 2021 and June 2022 were selected for this study.Cervical exfoliated cells were collected for dual-gene methylation testing,alongside the collection of basicpatient information,tumor biological markers,and endometrial thickness assessed through ultrasound.Usingthe histopathological diagnosis of endometrial tissue obtained via hysteroscopy as the gold standard,thesensitivity and specificity of dual-gene methylation testing for detecting endometrial cancer in women withabnormal uterine bleeding were analysed.Results In univariate analysis,age(P=0.001),body mass index(P=0.002),diabetes(P=0.012),menopause(P<0.001),CDO1 methylation(P<0.001),and CELF4 methylation(P<0.001)have an impact on the risk of endometrial cancer,and the differences are statistically significant.Binary logistic regression analysis results showed that the odds ratio(OR)value of body mass index was3.970(95%CI:[1.058,14.895],P=0.041),the OR value of menopause was 18.702(95%CI:[1.847,189.370],P=0.013),The OR values of CDO1 methylation and CELF4 methylation were 22.351(95%CI:[2.250,221.989],P=0.008),60.995(95%CI:[5.992,620.920],P=0.001),respectively.CISENDO(CDO1and CELF4)dual gene methylation detection has a sensitivity of 91.2%(95%CI:[76.3%,98.1%])anda specificity of 96.7%(95%CI:[93.0%,98.8%]);the sensitivity and specificity of ultrasound examinationare 55.9%(95%CI:[37.9%,72.8%])and 78.6%(95%CI:[71.9%,84.3%]);the sensitivity and specificityof carbohydrate antigen 125 were 32.4%(95%CI:[17.4%,50.5%])and 76.4%(95%CI:[69.0%,82.8%]).Conclusion For postmenopausal women,dual-gene methylation testing demonstrates higher sensitivity andspecificity compared to the currently utilized serum carbohydrate antigen 125 and ultrasound examinations,indicating a higher risk of endometrial cancer.