子宫内膜癌和卵巢癌患者血清唾液酸水平检测及其临床价值评估

目的评估血清唾液酸(SA)对子宫内膜癌和卵巢癌的辅助诊断价值。方法利用酶法和电化学发光法分别检测47例子宫内膜癌、30例子宫良性疾病,117例卵巢癌,83例卵巢良性肿瘤患者及60例健康对照者血清SA、糖类抗原125(CA125)和人附睾蛋白4(HE4)水平,以CA125、HE4作为对照指标评估SA诊断子宫内膜癌和卵巢癌的价值。结果早、晚期子宫内膜癌组和卵巢癌患者血清SA水平均明显高于健康组和子宫良性疾病组,差异有统计学意义(P0.05)。与血清CA125指标比较,无论以健康组还是子宫良性疾病组为对照,子宫内膜癌组患者血清SA受试者操作特性曲线下面积(ROC-AUC)比较差异无统计学意义(P0.05);卵巢癌组患者血清SA的ROC-AUC当以健康组为对照时,SA的ROC-AUC低于CA125,以卵巢良性疾病组为对照时则比较差异无统计学意义(P0.05)。在约登指数最大点处,以健康组作为对照时,SA对子宫内膜癌诊断的特异度明显高于CA125,差异有统计学意义(P0.05)。以卵巢良性疾病组为对照时,SA对卵巢癌诊断的敏感度和特异度与CA125和HE4比较,差异无统计学意义(P0.05)。结论 SA对子宫内膜癌和卵巢癌均有较高的敏感度和特异度,适用于两大妇科肿瘤的筛查。

Detection of serum sialic acid level in patients with endometrial cancer and ovarian cancer and its clinical value evaluation

Objective To evaluate the assisted diagnostic value of serum sialic acid (SA)in endometrial cancer and ovarian canc-er.Methods The serum levels of SA,CA125 and HE4 in 47 patients with endometrial cancer,30 patients with benign uterine disea-ses,117 patients with ovarian cancer,83 patients with benign ovarian tumor and 60 healthy controls were determined by using the enzymatic method and electrochemiluminescence method.The value of SA in the diagnosis of endometrial cancer and ovarian cancer was evaluated by comparing with CA125 and HE4 as the control indexes.Results The serum SA levels in the early and late stage endometrial cancer and ovarian cancer group were significantly higher than those in the healthy group and benign uterine disease group,the difference was statistically significant (P<0.05).Compared with serum CA125 index,no matter with the healthy group or benign uterine diseases group as the contro,the comparison of the area under the receiver operating characteristic curves (ROC-AUC)of serum SA in the endometrial cancer group had no statistical difference (P>0.05);with the healthy group as the control, the ROC-AUC of SA in the ovarian cancer group was lower than that of CA125,with the benign uterine disease group as the con-trol,the difference was statistically significant (P<0.05).At the largest Youden index point of ROC,with the healthy group as the control,the specificity of SA in diagnosing endometrial cancer was statistically higher than that of CA125,the difference was statis-tically significant (P<0.05).With the benign ovarian disease group as the control,the specificity and sensitivity of SA in diagno-sing endometrial cancer showed no statistical difference compared with those of CA125 and HE4(P>0.05).Conclusion SA has higher sensitivity and specificity for diagnosing endometrial cancer and ovarian cancer and is suitable for the screening of these two gynecological cancers.