探讨不同妇科肿瘤和疾病血清CA242水平的变化及其诊断价值

To Investigate the Changes in Serum CA242 Levels and Its Diagnostic Value in Patients with Different Gynecologic Tumors and Diseases

目的探讨不同妇科疾病患者血清CA242水平的变化及其诊断价值。方法收集2021年1月-2023年12月期间在医院就诊的妇科疾病患者471例,对比其与体检人群CA242的水平(100例)。对比不同妇科疾病患者同一部位良性病变和恶性病变的血清CA242水平。使用受试者工作曲线(ROC)分析CA242对妇科肿瘤的临床诊断价值。结果成熟畸胎瘤的血清CA242中位数最高(16.78IU/mL),卵巢癌(10.81IU/mL)、子宫腺肌症(10.25IU/mL)和输卵管癌(9.46IU/mL)患者血清CA242中位数高于其他妇科疾病和健康对照组(4.49IU/m L),且差异具有统计学意义。恶性卵巢病变的血清CA242水平高于良性卵巢病变,差异具有统计学意义(P<0.001)。子宫、子宫颈和输卵管部位的良、恶性病变血清CA242水平无统计学差异。使用CA242、CA125和HE4诊断卵巢癌的ROC曲线下面积分别为0.635、0.700和0.830,CA125和CA242联合诊断卵巢癌的ROC曲线下面积为0.726;CA125联合HE4诊断卵巢癌的ROC曲线下面积为0.862;CA242、CA125和HE4三者联合诊断卵巢癌的ROC曲线下面积为0.886。结论在不同的妇科疾病中观察到肿瘤标志物CA242表达水平有差异,且CA242对卵巢癌的临床诊断具有潜在价值,CA242、CA125和HE4三者联合诊断卵巢癌的临床价值较高。

Objective To explore the changes in serum CA242 levels in patients with different gynecologic diseases and their diagnostic value.Methods To collect 471 patients with gynecological diseases from January 2021 to December 2023,and compare their CA242 levels with those of the 100 physical examination population.Serum CA242 levels of benign and malignant lesions at the same site in patients with different gynecological diseases were compared.The clinical diagnostic value of CA242 for gynecologic neoplasms was analyzed using the subject's working curve(ROC).Results Mature teratomas had the highest median serum CA242(16.78 IU/mL),and patients with ovarian cancer(10.81 IU/mL),adenomyosis(10.25 IU/mL),and fallopian tube cancer(9.46 IU/mL)had higher median serum CA242 than those with other gynecologic diseases and healthy controls(4.49 IU/mL),and the difference was statistically significant.Serum CA242 levels were higher in malignant ovarian lesions than in benign ovarian lesions,and the difference was statistically significant(P<0.001).There was no statistically significant difference in serum CA242 levels between benign and malignant lesions in the uterus,cervix and fallopian tube sites.The area under the ROC curve for the diagnosis of ovarian cancer using CA242,CA125 and HE4 was 0.635,0.700 and 0.830,respectively.The area under the ROC curve for the combined diagnosis of ovarian cancer using CA125 and CA242 was 0.726;the area under the ROC curve for the diagnosis of ovarian cancer using CA125 combined with HE4 was 0.862;the area under the ROC curve for the combined diagnosis of ovarian cancer using CA242,CA125 and HE4 combined to diagnose ovarian cancer,the area under the ROC curve was 0.886.Conclusion Differences in the expression levels of tumor marker CA242 were observed in different gynecological diseases,and CA242 has potential value for the clinical diagnosis of ovarian cancer,and the combined diagnosis of ovarian cancer by CA242,CA125 and HE4 has high clinical value.