糖链抗原125、人附睾蛋白4联合磁共振成像在子宫内膜癌淋巴结转移中的预测价值

目的探讨糖链抗原125(CA125)、人附睾蛋白4(HE4)及磁共振成像(MRI)对子宫内膜癌(EC)患者淋巴结转移的预测价值。方法选取2017年1月至2020年12月武汉大学人民医院收治的171例EC患者作为研究对象进行回顾性分析。根据有无淋巴结转移分为两组,淋巴阳性组(n=142)和淋巴阴性组(n=29)。测定两组患者血清CA125、HE4水平,行下腹+盆腔MRI检查,分析CA125、HE4及MRI在EC患者淋巴结转移中的预测价值。结果术前CA125及HE4水平与国际妇产科联盟(FIGO)分期、病理分化程度、淋巴结转移及淋巴血管间隙浸润有关(P<0.05),HE4水平还与病灶直径、肌层浸润深度有关(P<0.05)。二元Logistic回归分析结果显示,深肌层浸润、脉管浸润、CA125≥32.7U/mL、HE4≥97.9pmol/L是影响淋巴结转移的独立因素。依据受试者工作特征(ROC)曲线确定CA125、HE4预测淋巴结转移的最佳截断值为32.7U/mL及97.9pmol/L。在不同检测手段中,MRI预测淋巴结转移风险的准确率最高,CA125、HE4及MRI三者联合检测...

The value of serum CA125 and HE4 combined with MRI in predicting lymph node metastasis of endometrial cancer

Objective To investigate the value of carbohydrate antigen 125(CA125), human epididymis protein 4(HE4) and magnetic resonance imaging(MRI) in predicting lymph node metastasis of endometrial cancer(EC). Methods 171 EC patients admitted to People′s Hospital of Wuhan University from January 2017 to December 2020 were selected as the subjects for retrospective analysis. According to the presence or absence of lymph node metastasis, the patients were divided into the lymph node positive group(n=142) and the lymph node negative group(n=29). Serum CA125 and HE4 levels and MRI of lower abdomen and pelvic cavity in 2 groups were measured, and the predictive value of CA125, HE4 and MRI in lymph node metastasis of EC patients was analyzed. Results Preoperative CA125 and HE4 levels were related to the international federation of gynecology and obstetrics(FIGO)stage, pathological differentiation degree, lymph node metastasis and lymphatic vascular space infiltration(P<0.05). HE4 level was also related to lesion diameter and muscle layer infiltration depth(P<0.05). Binary Logistic regression analysis showed that deep muscle layer infiltration, vascular infiltration, CA125≥32.7 U/mL, HE4≥97.9 pmol/L were independent factors affecting lymph node metastasis. According to receiver operating characteristic(ROC) curve, the optimal truncation values of CA125 and HE4 for predicting lymph node metastasis were 32.7 U/mL and 97.9 pmol/L. Among the different detection methods, MRI had the highest accuracy in predicting the risk of lymph node metastasis, and the combined detection of CA125, HE4 and MRI had the highest sensitivity and negative predictive value. Conclusions The sensitivity and negative predictive value of CA125+HE4+MRI are the highest, while the specificity and positive predictive value are lower. CA125≥32.7 U/mL, HE4≥97.9 pmol/L are independent factors affecting lymph node metastasis.