上皮性卵巢癌血清中肿瘤标志物水平及其临床意义（英文）

单冬勇; 成树林; 马邺晨; 彭红华

doi:10.11817/j.issn.1672-7347.2023.230090

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论著 | 更新时间：2023-09-19

上皮性卵巢癌血清中肿瘤标志物水平及其临床意义（英文）
Serum levels of tumor markers and their clinical significance in epithelial ovarian cancer
中南大学学报(医学版) 中南大学学报(医学版) 2023年48卷第7期页码：1039-1049
作者机构：

中南大学湘雅三医院肿瘤科，长沙 410013
作者简介：

SHAN Dongyong, Email: dandongyong@csu.edu.cn, ORCID: 0000-0002-1260-0543
PENG Honghua, Email: phhksc79@csu.edu.cn, ORCID: 0000-0002-9870-5636
基金信息：

the Natural Science Foundation of Hunan Province(2018JJ3791)
DOI：10.11817/j.issn.1672-7347.2023.230090
中图分类号：
CSTR：
纸质出版日期： 2023-07-28 ，

收稿日期： 2023-03-09 ，

单冬勇, 成树林, 马邺晨, 彭红华. 上皮性卵巢癌血清中肿瘤标志物水平及其临床意义[J]. 中南大学学报(医学版), 2023, 48(7): 1039-1049.

SHAN Dongyong, CHENG Shulin, MA Yechen, PENG Honghua. Serum levels of tumor markers and their clinical significance in epithelial ovarian cancer[J]. Journal of Central South University. Medical Science, 2023, 48(7): 1039-1049.
单冬勇, 成树林, 马邺晨, 彭红华. 上皮性卵巢癌血清中肿瘤标志物水平及其临床意义[J]. 中南大学学报(医学版), 2023, 48(7): 1039-1049. DOI：10.11817/j.issn.1672-7347.2023.230090

SHAN Dongyong, CHENG Shulin, MA Yechen, PENG Honghua. Serum levels of tumor markers and their clinical significance in epithelial ovarian cancer[J]. Journal of Central South University. Medical Science, 2023, 48(7): 1039-1049. DOI：10.11817/j.issn.1672-7347.2023.230090

摘要

目的

肿瘤标志物已广泛应用于临床。血清CA125检测是目前临床常用的上皮卵巢癌早期筛查和早期诊断方法之一，但使用单一特异性肿瘤标志物诊断上皮性卵巢癌比较困难。本研究采用肿瘤标志物组合检测法，比较各肿瘤标志物单独检测与联合检测在上皮性卵巢癌诊断中的价值。

方法

收集上皮性卵巢癌患者(

=65)和卵巢良性疾病患者(

=29)的临床资料。采用多肿瘤标志物蛋白质芯片检测癌抗原125(cancer antigen 125，CA125)、糖类抗原242(carbohydrate antigen 242，CA242)、甲胎蛋白(alpha-fetoprotein，AFP)、β-人绒毛膜促性腺激素(beta-human chorionic gonadotropin，β-HCG)、癌胚抗原(carcinoembryonic antigen，CEA)、癌抗原199(cancer antigen 199，CA1990)、神经元-特性烯醇化酶(neuron-specific enolase，NSE)、铁蛋白(Ferritin)、癌抗原153(cancer antigen 153，CA153)以及人生长激素(human growth hormone，HGH)的血清水平，比较其在卵巢良恶性肿瘤中的差异；χ

检验分析肿瘤标志物与卵巢上皮癌患者临床病理特征的相关性；Spearman秩关性分析上皮性卵巢癌CA125与其他肿瘤标志物表达水平及年龄与上述10种肿瘤标志物的相关性；采用灵敏度、特异度、阳性预测值、阴性预测值、约登指数及诊断效率分别评价各肿瘤标志物单项检测及联合检测的诊断价值。

结果

上皮性卵巢癌组中的β-HCG、NSE、CA153和CA125水平均高于卵巢良性疾病组。上皮性卵巢癌患者血清中NSE的水平与患者的临床分期相关。此外，上皮性卵巢癌患者血清中CA242、β-HCG、CEA、NSE、Ferritin、CA153水平与CA125水平呈正相关(分别

=0.497、

0.001；

=0.612、

0.001；

=0.358、

=0.003；

=0.680、

0.001；

=0.322、

=0.009；

=0.609、

0.001)， β-HCG、Ferritin、CA153水平与患者年龄呈正相关(分别

=0.256、

=0.040；

=0.325、

=0.008；

=0.249、

=0.046)。在上皮性卵巢癌诊断中，CA125单独检测的灵敏度、约登指数及诊断效率均高于其他9种肿瘤标志物单独检测的结果；CA153、CA199、CA242、Ferritin、CEA与CA125进行联合检测时，其灵敏度均高于CA125单独检测的灵敏度，其中CA125+CEA、CA125+Ferritin+CEA这2种组合的灵敏度分别为89.2%和90.8%，诊断效率均为84.1%，高于其他组合的诊断效率。CA125+CEA联合检测时其约登指数为0.616，高于其他组合。

结论

CA125在诊断上皮性卵巢癌方面具有较高的诊断价值。血清中的肿瘤标志物组合检测在上皮性卵巢癌中具有更高的灵敏度和特异度。

Abstract

Objective

Tumor markers have been widely used clinically. Detection of serum CA125 is one of the commonly used clinical methods for early screening and early diagnosis of epithelial ovarian cancer

but it is difficult to diagnose epithelial ovarian cancer with a single specific tumor marker. In this study

the combinatorial tumor marker detection method was used to compare the value of each tumor marker alone and different combinations in the diagnosis of epithelial ovarian cancer.

Methods

The clinical data of patients with epithelial ovarian cancer (

=65) and ovarian benign disease (

=29) were collected. Multiple tumor marker protein chip was used to detect cancer antigen 125 (CA125)

carbohydrate antigen 242 (CA242)

alpha-fetoprotein (AFP)

beta-human chorionic gonadotropin (β-HCG)

carcinoembryonic antigen (CEA)

cancer antigen 199 (CA199)

neuron-specific enolase (NSE)

Ferritin

cancer antigen 153 (CA153)

and human growth hormone (HGH) serum levels

and to compare the differences between the benign and malignant ovarian tumors. The correlation between tumor markers and clinicopathologic features for ovarian epithelial carcinoma was analyzed by χ

test. Spearman rank analysis showed the correlation between CA125 expression level and other tumor markers in epithelial ovarian cancer and the correlation between age and the above 10 tumor markers. Sensitivity

specificity

positive predictive value

negative predictive value

Youden index

and diagnostic efficiency were used to evaluate the diagnostic value of single tumor marker and the combination of tumor markers.

Results

The levels of β-HCG

NSE

CA153

and CA125 in the epithelial ovarian cancer group were higher than those in the ovarian benign disease group. The level of NSE in the serum of patients with epithelial ovarian cancer was related to the clinical stage of patients. In addition

the levels of CA242

β-HCG

CEA

NSE

Ferritin

CA153 in the serum of patients with epithelial ovarian cancer were positively correlated with CA125 (

=0.497

0.001;

=0.612

0.001;

=0.358

=0.003;

=0.680

0.001;

=0.322

=0.009;

=0.609

0.001

respectively)

and the levels of β-HCG

Ferritin

CA153 were positively correlated with the patient’s age (

=0.256

=0.040;

=0.325

=0.008;

=0.249

=0.046

respectively). In the diagnosis of epithelial ovarian cancer

the sensitivity

Youden index

and diagnostic efficiency of CA125 detection alone were higher than the results of the other 9 separate detections. When CA153

CA199

CA242

Ferritin

and CEA were combined with CA125

the sensitivity of the combined detection of different combinations was higher than that of CA125 alone. The combined detection sensitivities of CA125+CEA and CA125+Ferritin+CEA were 89.2% and 90.8%

respectively

and the diagnostic efficiencies were both 84.1%

which were higher than those of other combinations. The Youden index of CA125+CEA joint detection was 0.616

which was higher than those of other combinations.

Conclusion

CA125 has a high diagnostic value in the diagnosis of epithelial ovarian cancer. The detection of combined tumor markers in serum has higher sensitivity and specificity in epithelial ovarian cancer.

关键词

上皮性卵巢癌肿瘤标志物蛋白质芯片化学发光联合评估诊断价值

Keywords

epithelial ovarian cancertumor markerprotein chip-chemiluminescencecombined assessmentsdiagnostic value

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