子宫内膜癌患者血浆溶血磷脂酸、血清癌抗原125及人附睾蛋白4的表达及临床意义

目的:探讨子宫内膜癌患者血浆溶血磷脂酸(LPA)、血清癌抗原125(CA125)及人附睾蛋白4(HE4)的表达及与临床病理特征的关系。方法:选取2014年3月到2016年6月在同济大学附属第一妇婴保健院进行治疗的子宫内膜癌患者76例作为观察组,另选取我院同期收治的子宫内膜增生症患者50例作为良性病变组,再选取同期在我院体检结果为健康的志愿者50例作为对照组。比较三组受试者血浆LPA、血清CA125以及HE4水平。以病理检测结果为金标准,计算血浆LPA、血清CA125、HE4诊断子宫内膜癌的灵敏度、特异度、阳性预测值、阴性预测值。分析子宫内膜癌患者血浆LPA、血清CA125以及HE4水平与临床病理特征的关系。结果:观察组的血浆LPA、血清CA125以及HE4水平均高于对照组和良性病变组(P0.05),良性病变组的血浆中CA125水平高于对照组(P0.05)。血浆LPA、血清CA125以及HE4诊断子宫内膜癌的灵敏度、特异度、阳性预测值、阴性预测值比较无统计学差异(P0.05)。子宫内膜癌患者LPA水平与年龄、肿瘤直径无关(P0.05),与淋巴结转移、临床分期、分化程度、疾病类型有关(P0.05);CA125、HE4水平与年龄、疾病类型无关(P0.05),与淋巴结转移、临床分期、肿瘤直径、分化程度有关(P0.05)。结论:子宫内膜癌患者血浆LPA、血清CA125以及HE4水平偏高,LPA、CA125、HE4与部分临床病理参数相关,三指标对子宫内膜癌均有较高的诊断价值。

Expression of Plasma LPA, Serum CA125 and HE4 in Patients with Endometrial Carcinoma and Its Relationship with Clinicopathological Features

ABSTRACT Objective: To investigate the expression of plasma lysophosphatidic acid (LPA), serum cancer antigen 125 (CA125) and human epididymal secretory protein4 (HE4) in patients with endometrial carcinoma and its relationship with clinicopathological fea- tures. Methods: 76 patients with endometrial carcinoma who were treated in First Maternity and Infant Health Hospital Affiliated to Tongji University from March 2014 to June 2016 were selected as the observation group, 50 patients with endometrial atypical hyperpla- sia who were treated in our hospital in the same period were selected as benign lesions group, and 50 healthy volunteers who were under- went physical examination in our hospital at the same period were selected as control group. The levels of plasma LPA, CA125 and serum HE4 were compared between the three groups. The sensitivity, specificity, positive predictive value and negative predictive value of plasma LPA, serum CA125 and HE4 in endometrial carcinoma were calculated by using the pathological examination as the gold stan- dard. The relationship between the levels of plasma LPA, serumCA125 and HE4 clinicopathological features in patients with endometrial carcinoma were analysed. Results: The levels of plasma LPA, serum CA125 and HE4 in the observation group were significantly higher than those in the control group and benign lesion group (P<0.05). The level of plasma CA125 in benign lesion group was higher than that in the control group (P<0.05). There were no significant differences in the sensitivity, specificity, positive predictive value and negative predictive value of plasma LPA, serum CA125 and HE4 in endometrial cancer (P>0.05). The level of LPA in patients with endometrial carcinoma was not correlated with age and tumor diameter (P>0.05), but there was correlated with lymph node metastasis, clinical stage, differentiation degree and histological type(P<0.05). The levels of CA125 and HE4 were not correlated with age and histological type (P>0.05), but there were correlated with lymph node metastasis, clinical stage, tumor diameter and differentiation degree (P<0.05). Conclusion: The expressions of LPA, serum CA125 and HE4 in patients with endometrial carcinoma are high, LPA, CA125 and HE4 were correlated with some clinicopathological parameters, the three indicators have higher diagnostic value for endometrial carcinoma.