目的: 探究血栓四项联合Ca125及HE4检测在上皮性卵巢癌早期诊断及侵袭性预测中的效果。方法: 回顾性选取2023年6月-2024年8月在皖南医学院第二附属医院妇科初次行全面分期手术及肿瘤细胞减灭术且术后病理确诊为上皮性卵巢癌(epithelial ovarian cancer, EOC)的患者,将其中早期EOC病例(Ⅰ期、Ⅱ期)纳入未转移组,晚期EOC病例(Ⅲ期、Ⅳ期)纳入转移组,同期行手术治疗的卵巢良性肿瘤病例为良性组,各20例。比较三组患者的血栓四项、Ca125、HE4水平差异,分别将良性组、未转移组及转移组各指标进行比较分析,并绘制受试者特征曲线(receiver operating characteristic curve, ROC),并计算曲线下面积(area under curve, AUC)评估各指标单独及联合检测在上皮性卵巢癌早期诊断及侵袭性预测中的价值。结果: 三组患者间血栓四项、Ca125、HE4水平比较差异具有统计学意义(P＜0.05);良性组与未转移组比较显示,Ca125+HE4+血栓四项联合检测在上皮性卵巢癌早期诊断中特异性、敏感性最高,AUC为0.775;未转移组与转移组比较显示,Ca125+HE4+血栓四项联合检测在上皮性卵巢癌侵袭性预测中特异性、敏感性较高,AUC为0.950。结论: 血栓四项联合肿瘤标志物检测在上皮性卵巢癌早期诊断及侵袭性预测中具有较高的敏感性和特异性,可为今后早期诊断卵巢癌及术前完善侵袭性评估提供辅助、参考价值。
Objective: To explore the effect of four thrombus indexes combined with Ca125 and HE4 detection in early diagnosis and invasive prediction of epithelial ovarian cancer(epithelial ovarian cancer, EOC). Methods: From June 2023 to August 2024, patients with epithelial ovarian cancer (EOC) who underwent the first comprehensive staged surgery and cytoreductive surgery in gynecology department of the Second Affiliated Hospital of Southern Anhui Medical College were retrospectively selected. Early EOC cases (stage Ⅰ and Ⅱ) were included in the non-metastatic group, and late EOC cases (stage Ⅲ and Ⅳ) were included in the metastatic group, and surgery was performed at the same time. The differences of thrombus, Ca125 and HE4 levels among the three groups were compared. The indexes of benign group, non-metastatic group and metastatic group were compared and analyzed, and the receiver operating characteristic curve (ROC) was drawn, and the area under curve (AUC) was calculated to evaluate the value of individual and combined detection of each index in early diagnosis and invasion prediction of epithelial ovarian cancer. Results: There were significant differences in the levels of four thrombus indexes, Ca125 and HE4 among the three groups (P＜0.05). Compared with the non-metastasis group, the combined detection of Ca125+HE4+ four thrombus indexes in the benign group had the higher specificity and sensitivity in the early diagnosis of EOC, and the AUC was 0.775. Compared with the non-metastatic group and the metastatic group, the combined detection of Ca125+HE4+four thrombus indexes had the highest specificity and sensitivity in the prediction of invasion of EOC, with an AUC of 0.950. Conclusion: The detection of four thrombus indexes combined with tumor markers has high sensitivity and specificity in the early diagnosis and invasive prediction of EOC.
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