早期卵巢癌患者血浆D- 二聚体、血清白蛋白 联合HE4 检测的临床意义

Diagnostic value of D-dimer and serum albumin combined with HE4 in patients with early ovarian cancer

摘要:

目的 探讨D- 二聚体、血清白蛋白联合HE4 诊断早期卵巢癌的临床价值。方法 选取2015 年6 月-2016 年12 武汉市第一医院就诊经病理确诊为卵巢癌的患者50 例（疾病组）及同期良性卵巢肿瘤的44 例 患者（对照组），记录其基线资料。单因素分析两组基线资料的分布差异；多因素Logistic 回归分析两组患者 有差异的指标。同时，运用Pearson 相关性分析各指标与CA125 的相关性，ROC 曲线分析各因素对早期卵巢癌 的诊断价值。结果 两组患者的CA125、CA199、人附睾蛋白（HE4）、D- 二聚体、甲胎蛋白（AFP）、血清白 蛋白、ROMA 指数比较，差异有统计学意义（P <0.05）。多因素非条件Logistic 分析结果显示，D- 二聚体、 ROMA、HE4 和CA125 是患者罹患卵巢癌的危险因素[O^R=1.421、1.478、1.327、1.362，95%CI ：（1.164， 1.481）（1.292，1.470）（1.011，1.743）（1.305，1.638）]；血清白蛋白是患者罹患卵巢癌的保护因素[O^R=0.746（95%CI： 0.687，0.953）]。Pearson 相关性分析提示患者D- 二聚体（r =0.412）、HE4（r =0.563）、ROMA 指数（r =0.684） 与CA125 呈正相关，而血清白蛋白与CA125 则呈负相关（r =-0.432）。ROC 曲线提示血清白蛋白联合HE4、 D- 二聚体联合HE4、血清CA125 及ROMA 指数诊断早期卵巢癌的ROC 曲线下面积分别为0.859、0.765、 0.654 及0.700。4 者比较，血清白蛋白联合HE4 的AUC 最大，其敏感性为78.4%，特异性为100%。结论 血清 白蛋白联合HE4 能在一定程度上诊断早期卵巢癌，具有一定的临床诊断价值。

Abstract:

Objective To explore the diagnostic value of D-dimer and serum albumin combined with HE4 in patients with early ovarian cancer. Methods Totally 50 patients diagnosed with ovarian cancer (disease group) in our hospital from June 2015 to December 2016 and 44 patients with benign ovarian tumor (control group) were involved in this study. Clinical information was recorded. Single factor analysis was performed to identify differentially recorded factors. Multifactor logistic regression analysis was utilized to specify risk as well as protective factors. Correlation of factors with CA125 and their diagnostic value were analyzed by Pearson correlation analysis and ROC curve, respectively. Results Obvious difference in serum CA125, CA199, HE4, D-dimer, serum albumin AFP and ROMA index were founded between disease group and control group (P < 0.05). Logistic analysis showed that D-dimer, ROMA index, HE4 and CA125 were risk factors for ovarian cancer with O^R equal to 1.421 (95% CI: 1.164, 1.481, P = 0.037), 1.478 (95% CI: 1.292, 1.470, P = 0.034), 1.327 (95% CI: 1.011, 1.743, P = 0.042), 1.362 (95% CI: 1.305 and 1.638, P = 0.040). Serum albumin was a protective factor with O^R equal to 0.746 (95% CI: 0.687, 0.953, P = 0.039). Pearson correlation analysis indicated that D-dimer (r = 0.412), HE4 (r = 0.563) and ROMA index (r = 0.684) were positively related while serum albumin (r = -0.432) was negatively related with CA125 (P < 0.05). ROC curve suggested that AUC for serum albumin + HE4, D-dimer + HE4, serum CA125 and ROMA index were 0.859, 0.765, 0.654 and 0.700, respectively. Sensitivity and specificity of serum albumin combined with HE4 were 78.4% and 100%, respectively. Conclusion Serum albumin combined with HE4 is promising in diagnosis of early ovarian cancer.