徐晓芳,程黎明,陈樑,黄兴华,李怡巍,李宗恒
XU Xiaofang,CHENG Liming,CHEN Liang,HUANG Xinghua,LI Yiwei,LI Zongheng

• 1:德阳市人民医院
• 2:西南医科大学

摘要(Abstract)：

目的:分析血清人附睾蛋白4(HE4)、共刺激分子B7-H3(B7-H3)水平对宫颈癌术后患者预后的评估价值。方法:选取行腹腔镜宫颈癌根治术患者300例为宫颈癌组,280例宫颈上皮内瘤变患者为良性组,选择同期体检健康女性280例为对照组;观察宫颈癌组、良性组术后非月经期、对照组在非月经期间体检时的血清HE4、B7-H3水平,分析不同临床特征宫颈癌术后患者(年龄、月经状态、肿瘤直径、病理类型、FIGO分期、分化程度、淋巴结转移及浸润深度)的HE4、B7-H3水平;宫颈癌术后患者随访5年,分析生存状况、比较死亡与存活患者血清HE4、B7-H3表达水平,采用受试者工作特征(ROC)曲线下面积(AUC)分析HE4、B7-H3单独或联合检测对宫颈癌术后患者预后的评估价值。结果:宫颈癌组和良性组患者血清HE4、B7-H3水平高于对照组(P <0. 05),宫颈癌组HE4、B7-H3表达水平高于良性组(P <0. 05);不同FIGO临床分期、淋巴结转移、肿瘤分化程度的宫颈癌术后患者血清HE4、B7-H3表达水平比较,差异有统计学意义(P <0. 05); 300例宫颈癌术后患者持续随访5年,死亡率42. 67%(128/300),存活率57. 33%(172/300),死亡组血清HE4、B7-H3水平高于存活组(P <0. 05); HE4、B7-H3单一指标检测对宫颈癌术后患者预后的评估价值低于2项指标联合检测。结论:血清HE4联合B7-H3检测可有效提高宫颈癌术后患者预后评估的灵敏度与准确度。
Objective: To analyze the clinical significance of serum human epididymal protein 4( HE4) and costimulatory molecule B7-H3 expression levels in the prognosis of patients with cervical cancer. Methods: Three hundred patients with radical hysterectomy treated were selected as the cervical cancer group,280 patients with cervical intraepithelial neoplasia as the benign group,and 280 healthy females in the same period as the control group. The serum HE4 and B7-H3 levels of the cervical cancer group and the benign group during non-menstrual period after surgery and the control group during non-menstrual period in physical examination were observed; the expression levels of HE4 and B7-H4 in different clinical characteristics of cervical cancer( age,menstrual status,tumor diameter,pathological type,FIGO stage,degree of differentiation,lymph node metastasis and depth of invasion) were analyzed. Patients were followed up for 5 years after the operation of cervical cancer,survival status was analyzed and serum HE4 and B7-H4 expression levels were compared between dead and surviving patients. ROC curve( AUC) was used to analyze the prognostic value of HE4 and B7-H3 in patients after the operation by testing alone or in combination. Results: The expression levels of HE4 and B7-H3 in cervical cancer group and benign group were significantly higher than those in control group( P < 0. 05); the expression levels of HE4 and B7-H3 in cervical cancer group were significantly higher than those in benign group( P < 0. 05). Serum HE4 and B7-H3 expression levels in patients with different FIGO clinical stages,lymph node metastasis,and tumor differentiation after cervical cancer surgery were compared,differences were statistically significant( P < 0. 05). After 5 years of follow-up,300 patients with cervical cancer had a mortality rate of 42. 67%( 128/300) and a survival rate of 57. 33%( 172/300); the expression levels of HE4 and B7-H3 in the death group were higher than those in the survival group( P < 0. 05). The predictive value of HE4 and B7-H3 by testing alone was lower than that of HE4 + B7-H3 in predicting the clinical prognosis of postoperative cervical cancer by testing in combination. Conclusion: The detection of HE4 combined with B7-H3 can effectively improve the sensitivity and accuracy of prognostic evaluation of cervical cancer.

关键词(KeyWords)： 宫颈癌;预后;宫颈上皮内瘤变;血清人附睾蛋白4;共刺激分子B7-H3;临床意义
uterine cervical neoplasms;prognosis;cervical intraepithelial neoplasia;serum human epididymal protein 4(HE4);costimulatory molecule B7-H3(B7-H3);clinical significance

Abstract:

Keywords:

基金项目(Foundation): 四川省卫生和计划生育委员会科研课题(17PJ308)

作者(Author): 徐晓芳,程黎明,陈樑,黄兴华,李怡巍,李宗恒
XU Xiaofang,CHENG Liming,CHEN Liang,HUANG Xinghua,LI Yiwei,LI Zongheng

DOI: 10.19367/j.cnki.2096-8388.2020.09.024

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