[1]刘　检,李　敏,陆明洋,等.卵巢癌患者血液NLR，CA125，HE4水平联合检测的实验诊断和预后价值研究[J].现代检验医学杂志,2021,36(05):28-32.[doi:10.3969/j.issn.1671-7414.2021.05.006]
　LIU Jian,LI Min,LU Ming-yang,et al.Experimental Diagnosis and Prognostic Value of Combined Detection of BloodNLR, CA125 and HE4 Levels in Ovarian Cancer Patients[J].Journal of Modern Laboratory Medicine,2021,36(05):28-32.[doi:10.3969/j.issn.1671-7414.2021.05.006]
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卵巢癌患者血液NLR，CA125，HE4水平联合检测的实验诊断和预后价值研究()
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《现代检验医学杂志》[ISSN:/CN:]

卷:
第36卷
期数:
2021年05期
页码:
28-32
栏目:
论　著
出版日期:
2021-10-14

文章信息/Info

Title:
Experimental Diagnosis and Prognostic Value of Combined Detection of BloodNLR, CA125 and HE4 Levels in Ovarian Cancer Patients
文章编号:
1671-7414（2021）05-028-05
作者:
刘　检; 李　敏; 陆明洋; 等
( 苏州大学附属第三医院肿瘤生物诊疗中心，江苏常州 213003)
Author(s):
LIU Jian;  LI Min;  LU Ming-yang;  XU Bin;  ZHENG Xiao;  ZHOU Yi
(Department of Tumor Biological Treatment, the Third Affiliated Hospital of Soochow University, Jiangsu Changzhou213003，China)
关键词:
卵巢癌; 中性粒细胞/淋巴细胞比值; 糖类抗原125; 人附睾蛋白4
分类号:
R737.31；R730.43
DOI:
10.3969/j.issn.1671-7414.2021.05.006
文献标志码:
A
摘要:
目的　探讨中性粒细胞/淋巴细胞比值(neutrophil-to-lymphocyte ratio，NLR)、血清糖类抗原125(carbohydrate antigen 125，CA125)、血清人附睾蛋白4(human epididymis protein 4，HE4)在卵巢癌(Ovarian Cancer，OC)中的表达水平以及卵巢恶性肿瘤风险判定(risk of ovarian malignancy algorithm，ROMA)比值在OC中的诊断价值及疗效评估的临床意义。 方法　收集苏州大学附属第三医院2017年5月～2020年2月确诊的OC患者、卵巢良性疾病患者和健康体检者血清，检测各组受试者血液NLR，CA125，HE4以及ROMA比值的水平，比较各组表达水平的差异，评价检测指标在OC及相关疾病诊断中的敏感度和特异度。 结果　OC组NLR[3.62(1.22，13.11) vs 2.11 (1.03，4.81) vs 1.60(0.85 vs 2.98)]，CA125[420.80(10.75，4.22) vs 15.47(3.69，173.40) vs 13.81(6.02，56.47)]，HE4[203.85(40.11，1 500) vs 42.37(31.72，63.81) vs 42.22(23.61，102.40)]水平与良性疾病组和健康对照组相比，差异均具有统计学意义(χ2=60.22,81.31,93.23,均P<0.000 1)；NLR，CA125对OC诊断的敏感度高于HE4(82.8%, 81.0% vs 70.7%)，但特异度低于HE4 (68.9%，88.7% vs 100.0%)，HE4和ROMA比值对OC的诊断特异度最高；相关性分析显示NLR与OC患者的肿瘤数量、患者年龄、TNM分期显著相关(Z=2.338，P=0.019；Z=2.971，P=0.003；Z=2.819，P=0.005)；CA125和HE4的表达与OC患者的肿瘤数量、TNM分期、盆腔有无黏液显著相关(Z=2.759，4.228，3.418；2.419，3.767，2.122，均P<0.05)；CA125，HE4和NLR术后水平与术前水平相比显著降低，差异有统计学意义(Z=5.365，P <0.001；Z=2.222，P=0.026；Z=4.487，P<0.001)。CA125与HE4的联合检测，结合ROMA比值，具有更好的诊断效率，与NLR比值在OC诊疗中具有互补性。 结论　NLR联合血清CA125和HE4检测以及ROMA比值可提高OC诊断价值、在OC患者的病情评估及治疗效果中有积极意义。
Abstract:
Objective　To investigate the neutrophil-lymphocyte ratio(NLR)，serum carbohydrate antigen 125(CA125)，human epididymis protein 4(HE4) in ovarian cancer(OC). The diagnostic value and clinical significance of the risk of ovarianmalignant tumor analysis (ROMA) ratio in OC. Methods　Serum samples of patients with OC with ovarian diseases andhealthy people were collected in the Third Hospital Affiliated to Soochow University from May 2017 to February 2020. Thelevels of NLR，CA125，HE4 and ROMA ratio in blood of each group were detected, and the difference of expression level ineach group were compared. The sensitivity and specificity of detection indexes in the diagnosis of OC and related disease wereevaluated. Results　OC group NLR[3.62(1.22, 13.11) , 2.11 (1.03, 4.81) vs 1.60(0.85 vs 2.96)],CA125[420.80(10.75,4.22) vs15.47(3.69, 173.40) vs 13.81(6.02, 56.47)], HE4[203.85(40.11, 1 500) vs 42.37(31.72, 63.81) vs 42.22(23.61, 102.40)] levelscompared with benign disease group and health control group，the differences were statistically significant(χ2=60.22, 81.31,93.23, all P<0.000 1). The sensitivity of CA125 to the diagnosis of OC was higher than that of HE4(81.0% vs 70.7%)，but itsspecificity was lower than that of HE4(88.7% vs 100.0%)，and HE4 and ROMA had the highest diagnostic specificity for OC. Correlation analysis showed that NLR was significantly correlated with tumor number，age and TNM stage of OCpatients (Z=2.338，P=0.019; Z=2.971，P=0.003；Z=2.819，P=0.005). The expressions of CA125 and HE4 were significantlycorrelated with tumor number，TNM stage，and pelvic mucus (Z=2.759，4.228, 3.418; 2.419, 3.767, 2.122, all P<0.05),Postoperative levels of CA125，HE4，NLR was significantly lower than the preoperative level，and the difference wasstatistically significant(Z=5.365, P <0.001; Z=2.222, P=0.026; Z=4.487, P<0.001). The combined detection of CA125 and HE4，combined with ROMA ratio，had better diagnostic efficiency and was complementary with NLR ratio in OC diagnosis andtreatment. Conclusion　NLR combined with serum CA125，HE4 detection and ROMA ratio can improve the diagnostic valueof OC and have positive significance in the evaluation of the condition and treatment effect of OC patients.

参考文献/References:

[1] KUROKI L, GUNTUPALLI S R. Treatment ofepithelial ovarian cancer[J]. BMJ (Clinical Researched.), 2020, 371: m3773.
[2] ZENG Hongmei, CHEN Wanqing, ZHENG Rongshou,et al. Changing cancer survival in China during 2003-15: a pooled analysis of 17 population-based cancerregistries[J]. the Lancet Global Health, 2018, 6(5):e555-e567.
[3] DING Shaojie, LIN Qiao, ZHU Tianhong, et al. Isthere a correlation between inflammatory markersand coagulation parameters in women with advancedovarian endometriosis[J]. BMC Women’s Health, 2019,19(1): 169.
[4] HENDERSON J T, WEBBER E M, SAWAYA G F.Screening for ovarian cancer: updated evidence reportand systematic review for the US preventive servicestask force[J]. the Journal of the American MedicalAssociation, 2018, 319(6): 595-606.
[5] 张善弟，荆成宝，禹梅．血清CEA,CA125 和HE4联合检测对卵巢癌的诊断价值[J]. 现代检验医学杂志,2018,33(6):122-124, 131.ZHANG Shangdi, JING Chengbao, YU Mei. Clinicalvalue of combined detection of serum CEA,CA125 andHE4 in the diagnosis of ovarian cancer [J]. Journal ofModern Laboratory Medicine, 2018, 33 (6): 122-124, 131.
[6] DOLAN R D,MCSORLEY S T, HORGAN P G, etal. The role of the systemic inflammatory responsein predicting outcomes in patients with advancedinoperable cancer: Systematic review and metaanalysis[J]. Critical Reviews in Oncology/Hematology,2017, 116:134-146.
[7] CANDIDO J, HAGEMANN T. Cancer-relatedinflammation[J]. Journal of Clinical Immunology, 2013,33(Suppl 1): S79-S84.
[8] YANG Ruonan,CHANG Qian,MENG Xianchun,et al.Prognostic value of Systemic immune-inflammationindex in cancer: A meta-analysis[J]. Journal of Cancer,2018, 9(18): 3295-3302.
[9] SUNER A, CARR B I, AKKIZ H, et al. Inflammatorymarkers C-reactive protein and PLR in relation to HCCcharacteristics[J]. Journal of Translational Science,2019, 5(3): 10.
[10] ZHOU Ziquan , PANG Shuo, YU Xingchen, et al.Predictive values of postoperative and dynamic changesof inflammation indexes in survival of patients withresected colorectal cancer[J]. Current medical science,2018, 38(5) : 798-808.
[11] ZHANG Yi, LIN Shibu ,YANG Xianjin ,et al.Prognostic value of pretreatment systemic immuneinflammationindex in patients with gastrointestinalcancers[J]. Journal of Cellular Physiology, 2019,234(5):5555-5563.
[12] 李靖. 血清CA125, HE4 及ROMA 指数在良恶性卵巢癌鉴别中诊断价值[J]. 医学检验与临床, 2020, 31(10):16-18.LI Jing. The value of serum CA125, HE4 and ROMAindex in the differential diagnosis of ovarian cancer [J].Medical Laboratory Science and Clinics, 2020, 31 (10):16-18.
[13] NOMELINI R S, CARRIJO CHIOVATO A,ABDULMASSIH F, et al. Neutrophil-to-lymphocyteratio and platelet count as prognostic factors in ovarianmalignancies[J]. Journal of Cancer Research andTherapeutics, 2019, 15(6): 1226-1230.
[14] TOKMAK A, YILDIRIM G, ?ZTA? E, et al. Use ofneutrophil-to-lymphocyte ratio combined with CA-125 to distinguish endometriomas from other benignovarian cysts[J]. Reproductive Sciences (ThousandOaks, Calif.), 2016, 23(6): 795-802.
[15] 遆振宇, 高小鹏, 千东维, 等. 血清sPDL1 水平和外周血NLR 在判断晚期胆管癌患者生存预后中的意义[J]. 现代检验医学杂志, 2019, 34(6):41-46.DI Zhenyu, GAO Xiaopeng, QIAN Dongwei. Solubleprogrammed death-ligand 1 (sPDL1) and neutrophiltolymphocyteratio (NLR) predicts prognostic survivalin advanced biliary tract cancer patients treatedwith palliative chemotherapy[J]. Journal of ModernLaboratory Medicine, 2019, 34(6):41-46.
[16] 李四香, 李镭, 杨茗, 等. 肺癌患者血常规指标特征分析[J]. 华西医学,2020,35(9):1060-1067.LI Sixiang, LI Lei, YANG Ming. Analysis of bloodroutine test in lung cancer patients [J]. West ChinaMedical Journal, 2020, 35 (9): 1060-1067.
[17] YANG Desheng, LI Haini, SUN Xiaoyan, et al .Clinical usefulness of high levels of C-reactive proteinfor diagnosing epithelial ovarian cancer[J]. ScientificReports, 2020, 10(1):20056.
[18] LEANDERSSON P, ?KESSON A, HEDENFALKI, et al. A multiplex biomarker assay improves thediagnostic performance of HE4 and CA125 in ovariantumor patients[J]. PLoS One, 2020, 15(10): e0240418.
[19] 李金燕，吕伯乐．血清人附睾上皮分泌蛋白4、糖类抗原125 水平变化与卵巢癌患者临床分期的关联性[J]．肿瘤基础与临床, 2018,31(5):432-434.LI Jinyan, L? Bole. Human epididymal epithelialsecretory protein 4, saccharide antigen 125 levels andclinical stage of ovarian cancer [J]. Journal of Basic andClinical Oncology, 2018,31(5):432-434.

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备注/Memo

备注/Memo:
基金项目：国家自然科学基金（81902386）；常州市卫生青苗人才工程（CZAQM2020052）；常州市卫健委青年人才科技项目（QIV202014）。
作者简介：刘检（1985-），男，硕士，主管检验师，研究方向：肿瘤分子生物学及免疫学，E-mail:xiaoliu2065@163.com。
通讯作者：周怡（1985-），女，硕士，主管检验师，研究方向：肿瘤分子生物学及免疫学，E-mail:CZzhouyiz600@hotmail.com。
更新日期/Last Update: 1900-01-01