血清PTPN3、DCLK1、CYFRA21-1在宫颈癌早期诊断和预后评估中的价值

Clinical value of serum PTPN3, DCLK1, and CYFRA21-1 in the early diagnosis and prognosis evaluation of cervical cancer

摘要:

目的 探讨血清蛋白酪氨酸磷酸酶非受体型3（PTPN3）、双皮质层感蛋白样激酶1（DCLK1）和细胞角蛋白19片段（CYFRA21-1）在宫颈癌早期诊断和预后评估中的价值。方法 选取2022年1月—2023年6月江南大学附属医院收治的92例宫颈癌患者作为宫颈癌组，取同期在该院确诊的50例宫颈上皮内瘤变（CIN）患者作为CIN组，取同期在该院健康体检的50例女性为对照组。观察各组血清PTPN3、DCLK1和CYFRA21-1水平，评价血清PTPN3、DCLK1和CYFRA21-1在宫颈癌中的诊断效能，及与临床指标和预后的关系。结果 宫颈癌组患者血清PTPN3、DCLK1和CYFRA21-1水平均高于CIN组（P <0.05），CIN组血清PTPN3、DCLK1和CYFRA21-1水平均高于对照组（P <0.05）。受试者工作特征曲线结果显示，血清PTPN3诊断宫颈癌的敏感性为65.2%（95% CI：0.546，0.749），特异性为96.0%（95% CI：0.863，0.995）；血清DCLK1诊断宫颈癌的敏感性为76.1%（95% CI：0.661，0.844），特异性为88.2%（95% CI：0.757，0.955）；血清CYFRA21-1诊断敏感性为89.1%（95% CI：0.809，0.947），特异性为98.1%（95% CI：0.894，0.999）；联合检测诊断宫颈癌的敏感性为92.4%（95% CI：0.849，0.969），特异性为100.0%（95% CI：0.929，1.000）。低分化、人乳头瘤病毒阳性、临床分期Ⅱ期、有淋巴结转移宫颈癌患者血清PTPN3、DCLK1和CYFRA21-1水平均较高（P <0.05）。随访1年发现，死亡组患者血清PTPN3、DCLK1和CYFRA21-1水平均高于存活组（P <0.05）。结论 血清PTPN3、DCLK1和CYFRA21-1水平与宫颈癌病情的严重程度和预后密切相关，在宫颈癌早期诊断和预后评估中具有重要临床价值。

Abstract:

Objective To investigate the clinical value of serum protein tyrosine phosphatase non-receptor type 3 (PTPN3), doublecortin-like kinase 1 (DCLK1), and cytokeratin 19 fragment (CYFRA21-1) in the early diagnosis and prognosis evaluation of cervical cancer.Methods Ninety-two patients with cervical cancer admitted to Jiangnan University Affiliated Hospital from January 2022 to June 2023 were selected as the cervical cancer group. Fifty patients diagnosed with cervical intraepithelial neoplasia (CIN) during the same period were selected as the CIN group, and fifty healthy women undergoing routine heath checkups during the same period were selected as the control group. The changes in serum levels of PTPN3, DCLK1, and CYFRA21-1 in each group were observed. The diagnostic efficacy of serum PTPN3, DCLK1, and CYFRA21-1 levels in cervical cancer and their associations with clinical indicators and prognosis were evaluated.Results The serum levels of PTPN3, DCLK1, and CYFRA21-1 in the cervical cancer group were significantly higher than those in the CIN group (P < 0.05). The serum levels of PTPN3, DCLK1, and CYFRA21-1 in the CIN group were significantly higher than those in the control group (P < 0.05). The receiver operating characteristic curve analysis demonstrated that the sensitivity of serum PTPN3 for diagnosing cervical cancer was 65.2% (95% CI: 0.546, 0.749), with a specificity of 96.0% (95% CI: 0.863, 0.995). The sensitivity of serum DCLK1 was 76.1% (95% CI: 0.661, 0.844), with a specificity of 88.2% (95% CI: 0.757, 0.955). The sensitivity of serum CYFRA21-1 was 89.1% (95% CI: 0.809, 0.947), with a specificity of 98.1% (95% CI: 0.894, 0.999). Combined detection of these indicators achieved a sensitivity of 92.4% (95% CI: 0.849, 0.969) and a specificity of 100.0% (95% CI: 0.929, 1.000) for diagnosing cervical cancer. Additionally, serum levels of PTPN3, DCLK1, and CYFRA21-1 were significantly elevated in patients with poorly differentiated tumors, human papillomavirus positivity, clinical stage II disease, and lymph node metastasis (P < 0.05). After one year of follow-up, the serum levels of PTPN3, DCLK1, and CYFRA21-1 in the death group were significantly higher than those in the survival group (P < 0.05).Conclusion Serum levels of PTPN3, DCLK1, and CYFRA21-1 are closely related to the severity and prognosis of cervical cancer and have significant clinical value in the early diagnosis and prognosis evaluation of cervical cancer.