卵巢癌患者血清可溶性间皮素相关蛋白的检测及其意义

目的 评价血清可溶性间皮素相关蛋白（SMRP）对卵巢癌的诊断价值.方法 采用ELISA检测了63例卵巢癌患者、85例妇科良性疾病患者和51例健康对照个体血清SMRP水平.以受试者工作特征（ROC）曲线分析了SMRP对卵巢癌的诊断价值,并分析其与CA125联合使用是否有助于提高卵巢癌的诊断准确性.结果 卵巢癌患者血清SMRP水平显著高于妇科良性疾病患者和健康个体,且与患者的FIGO分期有关（P值均小于0.01）.CA125的ROC曲线下面积（AUC）与SMRP相近（CA125：SMRP＝0.81：0.77,P=0.45）.SMRP的最佳诊断界值为1.67 nmol/L,此时SMRP的诊断敏感性（95%可信区间）为0.82（0.73-0.90）,特异性（95%可信区间）为0.66（0.54-0.78）.采用系列诊断实验联合CA125与SMRP时,其联合诊断敏感性为0.67,特异性为0.96;采用平行诊断实验联合CA125与SMRP时,其联合诊断敏感性为0.97,特异性为0.48.结论 SMRP对卵巢癌的诊断以及分期具有一定的价值,联合使用CA125与SMRP更有助于提高卵巢癌的诊断准确性.

Serum soluble mesothelin related proteins detection in patients with ovarian cancer and its clinical indications

Objective To evaluate the diagnostic accuracy of serum soluble mesothelin related proteins （SMRP） in patients with ovarian cancer. Methods Serum SMRP level in 63 patients with ovarian cancer,85 patients with gyneco- logical benign disease and 51 healthy individuals was detected by ELISA. The diagnostic performance of SMRP and CA125 were evaluated and compared by receiver operating characteristic （ROC） curve analysis. The diagnostic value of combined using SMRP and CA125 was also investigated by parallel and series test based on the optimal threshold d6- rived from ROC curve. Results Increased serum SMRP concentration,which was positively correlated with FIGO sta- ges,was observed in patients with ovarian cancer,when compared with patients with gynecological benign disease and healthy individuals. The area under curve （AUC） of SMRP was comparable with CA125 （0.77 vs 0. 81,P=0. 46 for comparison）. At the threshold of 1.67 nmol/L （the optimal threshold with highest Youden index）, the diagnostic sensi- tivity （95 confidence interval,95MCI） and specificity （95CI） of SMRP was 0.82（0. 73-0. 90） and 0. 66 （0. 54- 0.78）, respectively. Further more, in series test based on SMRP and CA125, the diagnostic specificity increased to 0.96,while sensitivity decreased to 0. 67. By contrast, the diagnostic specificity decreased to 0.48 and sensitivity in- creased to 0.97in parallel test. Conclusion Serum SMRP was a promising diagnostic biomarker,as well as a potential prognosis factor for ovarian cancer. Combined use of serum SMRP and CA125 could improve the diagnostic accuracy of ovarian cancer.