宫颈癌患者血清Hsa_circ_0084912水平及其临床意义

Serum Hsa_circ_0084912 level in patients with cervical cancer and its clinical significance

目的探讨宫颈癌患者血清中Hsa_circ_0084912的水平及其临床意义。方法选取2021年1月至2023年6月该院收治的宫颈癌患者110例(宫颈癌组)、宫颈上皮内瘤变(CIN)患者60例(CIN组)及在该院体检的健康女性50例(对照组)作为研究对象。比较各组血清Hsa_circ_0084912、鳞状上皮细胞癌抗原(SCCA)及癌胚抗原(CEA)水平;比较不同临床病理特征的宫颈癌患者血清Hsa_circ_0084912水平。绘制受试者工作特征(ROC)曲线分析血清Hsa_circ_0084912、SCCA及CEA水平对宫颈癌的诊断价值。采用Pearson相关分析宫颈癌患者血清Hsa_circ_0084912水平与SCCA、CEA水平的相关性。结果宫颈癌组血清Hsa_circ_0084912、SCCA、CEA水平均明显高于CIN组和对照组(P<0.001),且CIN组血清Hsa_circ_0084912水平明显高于对照组(P<0.001)。Ⅲ~Ⅳ期、低分化、有淋巴结转移、浸润深度≥1/2肌层、高危型HPV阳性、SCCA阳性及CEA阳性的宫颈癌患者血清中Hsa_circ_0084912水平明显高于Ⅰ~Ⅱ期、中高分化、无淋巴结转移、浸润深度<1/2肌层、高危型HPV阴性、SCCA阴性及CEA阴性的宫颈癌患者(P<0.05)。ROC曲线分析结果显示,血清Hsa_circ_0084912、SCCA、CEA诊断宫颈癌的曲线下面积(AUC)分别为0.870(95%CI:0.809~0.931)、0.819(95%CI:0.757~0.881)、0.743(95%CI:0.686~0.801),小于3项指标联合诊断宫颈癌的AUC[0.916(95%CI:0.857~0.981)],差异均有统计学意义(Z=3.628,P=0.041;Z=6.713,P<0.001;Z=8.425,P<0.001)。Hsa_circ_0084912诊断宫颈癌的AUC大于SCCA、CEA诊断宫颈癌的AUC,差异均有统计学意义(Z=3.851,P=0.036;Z=7.260,P<0.001)。相关分析显示,宫颈癌患者血清Hsa_circ_0084912水平与SCCA、CEA水平均呈正相关(r=0.780、0.619,P<0.001)。结论宫颈癌患者血清Hsa_circ_0084912水平呈高表达,其高表达与疾病进展有关,Hsa_circ_0084912联合SCCA、CEA检测可提高对宫颈癌的诊断价值。

Objective To investigate the level and clinical significance of serum Hsa_circ_0084912 in the patients with cervical cancer.Methods A total of 110 patients with cervical cancer(cervical cancer group),60 patients with cervical intraepithelial neoplasia(CIN,CIN group)admitted to this hospital and 50 healthy women(control group)underwent physical examination in this hospital from January 2021 to June 2023 were selected as the study subjects.The levels of serum Hsa_circ_0084912,squamous epithelial cell carcinoma antigen(SCCA)and carcinoembryonic antigen(CEA)were compared among the various groups;the serum Hsa_circ_0084912 level was analyzed and compared among the different clinical and pathological characteristics of the patients with cervical cancer.The receiver operating characteristic(ROC)curve was drawn to analyze the diagnostic value of serum Hsa_circ_0084912,SCCA,and CEA levels for cervical cancer.The Pearson correlation was used to analyze the correlation between serum Hsa_circ_0084912 level with SCCA and CEA levels in cervical cancer patients.Results The serum Hsa_circ_0084912,SCCA and CEA levels in the cervical cancer group were significantly higher than those in the CIN group and control group(P<0.001),moreover the serum Hsa_circ_0084912 level in the CIN group was significantly higher than that in the control group(P<0.001).The serum Hsa_circ_0084912 level in the cervical cancer patients with stageⅢ-Ⅳ,low differentiation,lymph node metastasis,infiltration depth≥1/2 muscle layer,high-risk HPV positive,SCCA positive and CEA positive was significantly higher than that of cervical cancer patients with stageⅠ-Ⅱ,medium high differentiation,no lymph node metastasis,infiltration depth<1/2 muscle layer,high-risk HPV negative,SCCA negative and CEA negative(P<0.05).The ROC curve analysis results showed that the area under the curve(AUC)of serum Hsa_circ_0084912,SCCA and CEA for diagnosing cervical cancer were 0.870(95%CI:0.809-0.931),0.819(95%CI:0.757-0.881)and 0.743(95%CI:0.686-0.801)respectively,which were smaller than AUC[0.916(95%CI:0.857-0.981)]of 3 indicators combination detection for diagnosing cervical cancer,and the difference was statistically significant(Z=3.628,P=0.041,Z=6.713,P<0.001;Z=8.425,P<0.001).AUC of Hsa_circ_0084912 for diagnosing cervical cancer was greater than that of SCCA and CEA,and the difference was statistically significant(Z=3.851,P=0.036;Z=7.260,P<0.001).The correlation analysis showed that the serum Hsa_circ_0084912 level in cervical cancer patients was positively correlated with the SCCA and CEA levels(r=0.780,0.619,P<0.001).Conclusion The serum Hsa_circ_0084912 level in cervical cancer patients is highly expressed,and its high expression is related to disease progression.The detection of Hsa_circ_0084912 combined with SCCA and CEA could increase the diagnostic value to cervical cancer.