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人类白细胞抗原-E对子宫内膜癌诊断及预后判断的价值分析
作者:吴世丽1  许莉1  陈永香2 
单位:1. 海口市妇幼保健院 妇产科, 海南 海口 570001;
2. 海口市妇幼保健院 检验科, 海南 海口 570001
关键词:子宫内膜癌 人类白细胞抗原-E 糖类抗原125 人附睾分泌蛋白4 
分类号:R737.33
出版年·卷·期(页码):2021·49·第一期(23-27)
摘要:

目的: 分析血清人类白细胞抗原-E(sHLA-E)对子宫内膜癌诊断及预后判断的价值。方法: 选择2016年6月至2019年6月在本院接受治疗的82例子宫内膜癌患者作为研究对象,即为子宫内膜癌组;选择同期80例子宫良性病变患者为对照,即为子宫良性病变组;选择同期健康体检的60例健康者作为健康组。对3组研究对象的临床资料进行分析。结果: 3组研究对象糖类抗原125(CA125)、人附睾分泌蛋白4(HE4)以及sHLA-E水平比较差异均有统计学意义(F=290.928,P<0.001;F=382.416,P<0.001;F=52.673,P<0.001),子宫内膜癌组高于子宫良性病变组和健康组,子宫良性病变组高于健康组,随病情的严重程度呈现上升趋势(P<0.05);子宫内膜癌临床分期为Ⅲ、Ⅳ期的患者sHLA-E水平高于Ⅰ、Ⅱ期,差异具有统计学意义(t=2.399,P=0.019);随访18个月,子宫内膜癌复发患者sHLA-E水平明显高于无复发患者,差异具有统计学意义(t=2.088,P=0.040)。Pearson相关性分析的结果显示,子宫内膜癌患者sHLA-E水平与CA125、HE4水平均呈正相关(r=0.513,P<0.05;r=0.539,P<0.05)。ROC曲线分析结果显示,sHLA-E水平在诊断子宫内膜癌时的AUC为0.823(95%CI 0.755~0.878,P<0.01),敏感度为73.17%,特异度为78.75%。结论: 子宫内膜癌患者sHLA-E水平明显高于子宫良性病变患者和正常人群,且随着病情严重程度及临床分期呈现上升趋势;检测sHLA-E水平可有助于子宫内膜癌患者的诊疗及预后评估。

Objective: To analyze the value of human leukocyte antigen-E(sHLA-E) in the diagnosis and prognosis evaluation of endometrial cancer. Methods: 82 endometrial cancer patients who were treated in the hospital from June 2016 to June 2019 were selected as the endometrial cancer group. 80 patients with benign uterine lesions in the same period were aelected as benign uterine lesions group. Another 60 healthy people in the same period were selected as health groups. The clinical data of subjects in three groups were analyzed.Results: The levels of serum CA125, HE4, and sHLA-E of the three groups were significant (F=290.928, P<0.001; F=382.416, P<0.001; F=52.673, P<0.001), the endometrial cancer group was higher than the uterine benign lesions group and the healthy group, and the uterine benign lesions group was higher than the healthy group, showing an upward trend with the severity of the disease (P<0.05); The sHLA-E level of patients with clinical stage Ⅲ and Ⅳ was higher than that of Ⅰ and Ⅱ, the difference was significant (t=2.399, P=0.019); After 18 months of follow-up, the sHLA-E level of patients with recurrence of endometrial cancer was significantly higher than that of patients without recurrence, the difference was significant (t=2.088, P=0.040). The results of Pearson correlation analysis showed that serum sHLA-E levels in patients with endometrial cancer were positively correlated with CA125 and HE4 (r=0.513, P<0.05; r=0.539, P<0.05). ROC curve analysis results showed that the AUC of serum sHLA-E level in the diagnosis of endometrial cancer was 0.823 (95% CI 0.755-0.878, P<0.01), the sensitivity was 73.17% and the specificity was 78.75%.Conclusion: The serum sHLA-E level of patients with endometrial cancer is significantly higher than that of normal people and patients with benign uterine lesions, and as the severity of the disease and the clinical stage show an upward trend, the detection of serum sHLA-E level can help the diagnosis, treatment and prognosis evaluation of patients with endometrial cancer.

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