摘要
目的探讨血清β-人绒毛膜促性腺激素(β-HCG)、糖类抗原199(CA199)和促甲状腺激素(TSH)联合检测诊断子宫内膜癌的临床价值。方法选取2018年1月至2021年1月间上海市松江区妇幼保健院收治的82例子宫内膜癌患者、50例子宫内膜增生患者和50例体检健康女性,检测三组受试者和不同病理学分级、临床分期子宫内膜癌患者血清CA199、TSH和β-HCG水平,通过ROC曲线评估联合诊断的价值。结果子宫内膜癌组患者CA199、TSH和β-HCG水平均高于子宫内膜增生组和健康对照组,子宫内膜增生组患者CA199、TSH和β-HCG水平均高于健康对照组,差异均有统计学意义(均P<0.05)。子宫内膜癌G3级患者CA199、TSH和β-HCG水平均高于G2级和G1级,G2级患者CA199、TSH和β-HCG水平均高于G1级,差异均有统计学意义(均P<0.05)。子宫内膜癌Ⅰ期患者CA199、TSH和β-HCG水平与Ⅱ期比较,无统计学差异(P>0.05);Ⅲ期患者CA199、TSH和β-HCG水平均高于Ⅰ期和Ⅱ期,Ⅳ期患者CA199、TSH和β-HCG水平均高于Ⅰ期、Ⅱ期和Ⅲ期,差异均有统计学意义(均P<0.05)。ROC曲线分析显示,CA199、TSH和β-HCG单独诊断子宫内膜癌的AUC分别为0.902、0.769、0.962,三项联合诊断的AUC为0.980,诊断准确性高。根据最佳临界值,当CA199的cut-off值为28.51U/ml时,其敏感度为69.5%,特异度为100%;当TSH的cut-off值为2.83uIU/ml时,其敏感度为73.2%,特异度为73.0%;当β-HCG的cut-off值为4.07IU/L时,其敏感度为84.1%,特异度为95.0%;当联合cut-off值为57.32时,其敏感度为98.8%,特异度为89.0%。结论血清CA199、TSH和β-HCG水平与子宫内膜癌的发生发展密切相关,三者联合诊断的准确性高于单独诊断,有较高的诊断价值。
Objective To explore the value of a combination detection of serum β-human chorionic gonadotropin(β-HCG), carbohydrate antigen 199(CA199) and thyroid-stimulating hormone(TSH) for the detection of endometrial cancer. Methods From January 2018 to January 2021, 82 patients with endometrial cancer, 50 patients with endometrial hyperplasia, and 50 healthy women were selected at Shanghai Songjiang District Maternal and Child Health Hospital. The patients in each group and different pathological grades and clinical stages were detected and analyzed. The serum levels of CA199, TSH, and β-HCG were detected among the three groups and patients of different pathological grading and clinical staging of endometrial cancer. The diagnostic value of the combination detection was evaluated using the receiver operating characteristic(ROC) curve. Results The levels of CA199, TSH and β-HCG were significantly higher in the endometrial cancer group than in the endometrial hyperplasia group and the healthy control group, and higher in the endometrial hyperplasia group than in the healthy control group(all P<0.05). Moreover, the levels of CA199, TSH and β-HCG were significantly higher in patients with stage G3 endometrial cancer than in patients with stage G2 and stage G1 endometrial cancer, and higher in those with stage G2 endometrial cancer than stage G1 endometrial cancer(all P<0.05). There was no statistical difference in the levels of CA199, TSH and β-HCG between stage Ⅰ and stage Ⅱ endometrial cancer(P>0.05). The levels of CA199, TSH and β-HCG were significantly higher in patients with stage Ⅲ endometrial cancer than in patients with stage Ⅰ and Ⅱ endometrial cancer and higher in patients with stage Ⅳ endometrial cancer than in patients with stage Ⅰ, Ⅱ and Ⅲ endometrial cancer(all P<0.05). ROC curve analysis showed that areas under two ROC curves(AUCs) was 0.902, 0.769 and 0.962, respectively for each of CA199, TSH, β-HCG and 0.980 for the combination detection for the diagnosis of endometrial cancer. The sensitivity and specificity were 69.5% and 100.0%, 73.2% and 73.0%, and 84.1% and 95.0%, respectively when cutoff value was set at 28.51 U/ml, 2.83 uIU/ml and 4.07 IU/L, respectively for CA199, TSH, and β-HCG. When a cutoff value of 57.32 was set for the combination detection, the sensitivity and specificity were 98.8% and 89.0%, respectively. Conclusion Serum levels of CA199, TSH, and β-HCG are closely associated with the occurrence and development of endometrial cancer. The accuracy of the combination detection of the three factors is superior to each of the single detection for the diagnosis of endometrial cancer, and it has a high diagnostic value.
作者
吴琰
张辉
卫群
WU Yan;ZHANG Hui;WEI Qun(Department of Laboratory Medicine,Shanghai Songjiang District Maternal and Child Health Hospital,Shanghai 201620,China)
出处
《中国肿瘤临床与康复》
2022年第2期154-158,共5页
Chinese Journal of Clinical Oncology and Rehabilitation
关键词
CA199
TSH
Β-HCG
子宫内膜肿瘤
诊断价值
Carbohydrate antigen 199
Thyroid-stimulating hormone
β-human chorionic gonadotropin
Endometrial neoplasms
Diagnostic value
