血清CA724、CYFRA21-1及PIVKA-Ⅱ诊断卵巢癌价值

Analysis of the value of serum CA724, CYFRA21-1 and PIVKA- II levels for diagnosing patients with ovarian cancer

目的:探讨血清糖类抗原724(CA724)、细胞角蛋白19片断(CYFRA21-1)及异常凝血酶原(PIVKA-Ⅱ)在诊断卵巢癌的应用价值。方法:选取本院肿瘤科收治的卵巢癌患者46例作为卵巢癌组,卵巢良性肿瘤患者50例为良性肿瘤组,健康体检50例为健康对照组,采用化学发光法检测血清CA724、CYFRA21-1、PIVKA-Ⅱ水平,绘制受试者工作者特征曲线(AUC)比较分析。结果:血清CA724、CYFRA21-1、PIVKA-Ⅱ水平及组内阳性率卵巢癌组>良性肿瘤组>对照组(P<0.05);CA724的AUC为0.845,诊断敏感性为72.1%,特异性为87.9%;CYFRA21-1的AUC为0.813,诊断敏感性为67.4%,特异性为83.5%;PIVKA-Ⅱ的AUC为0.729,临界值为>24.74 U/L,诊断敏感性为61.4%,特异性为91.0%;CA724+CYFRA21-1、CA724+PIVKA-Ⅱ、CYFRA21-1+PIVKA-Ⅱ两两联合诊断卵巢癌的阳性率均较高(81.6%、82.6%、82.2%),但CA724+CYFRA21-1检测灵敏度、诊断准确率高于其他两组,3项指标联合检测的灵敏度、阳性率、诊断准确率最高,且特异性未见明显降低。结论:血清CA724、CYFRA21-1、PIVKA-Ⅱ对卵巢癌具有较高的辅助诊断价值,且三者联合检测可提高卵巢癌阳性检出率。

Objective:To investigate the value of serum levels of carbohydrate antigen 724(CA724),cytokeratin 19 fragment(CYFRA21-1)and abnormal prothrombin(PIVKA-II)for diagnosing patients with ovarian cancer.Methods:46 patients with ovarian cancer were selected in study group,50 patients with benign ovarian tumor were selected in control group,and 50 healthy women were elected in healthy control group.The levels of serum CA724,CYFRA21-1 and PIVKA-II were detected by chemiluminescence.The area under curve(AUC)of receiver operator characteristic was used for analyzing the value of levels of serum CA724,CYFRA21-1 and PIVKA-II.Results:The levels of serum CA724,CYFRA21-1 and PIVKA-II of patients in study group were the highest among the three groups,but were the lowest in healthy control group(P<0.05).The value of AUC,the sensitivity and the specificity of CA724 level were 0.845,72.1%,and 87.9%,respectively,the value of AUC,the sensitivity and the specificity of CYFRA21-1 level were 0.813,67.4%,and 83.5%,respectively,and the value of AUC,the sensitivity and the specificity of PIVKA-II were 0.729,61.4%,and 91.0%,respectively.The critical value of CYFRA21-1 level was over 24.74 U/L.And the diagnosis positive rates of A724 level combined with CYFRA21-1 level,CA724 level combined with PIVKA-II level,CYFRA21-1 level combined with PIVKA-II level combined detections were 81.6%,82.6%,and 82.2%,respectively.The sensitivity and accuracy of CA724 level combined with CYFRA21-1 level were higher than those of CA724 level combined with PIVKA-II level or CYFRA21-1 level combined with PIVKA-II level.The sensitivity,positive rate and diagnostic accuracy of the combination of CA724 level,CYFRA21-1 level and PIVKA-II level had increased significantly,while the specificity hadn’t decreased.Conclusion:Serum CA724,CYFRA21-1and PIVKA-II levels have high value for diagnosing ovarian cancer,and the combination of the Serum CA724,CYFRA21-1and PIVKA-II levels can increase the positive rate of ovarian cancer diagnosed significantly.