血清HE4和CEA水平在评估老年慢性盆腔炎患者转归卵巢癌风险中的价值

摘要

目的 分析人附睾分泌蛋白4(human epididymis secretory protein 4,HE4)和癌胚抗原(carcinoembryonic antigen, CEA)对老年慢性盆腔炎患者转归卵巢癌风险的评估价值.方法 回顾性分析本院2015年1月至2017年1月门诊收治的174例老年慢性盆腔炎患者的临床资料,根据盆腔病变组织病理学诊断结果,将患者分为卵巢癌组(72例)和良性病变组(102例),选取老年健康女性80例纳入对照组.比较各组研究对象HE4和CEA表达水平,通过Cox回归分析HE4和CEA表达水平对慢性盆腔炎患者预后转归的评估价值.结果 卵巢癌组研究对象HE4和CEA表达水平均显著高于良性病变组和对照组(P＜0.05).不同卵巢癌类型患者血清HE4、CEA表达水平比较差异均无显著性(P＞0.05).不同卵巢癌TNM分期患者血清HE4、CEA表达水平比较均具有显著差异(P＜0.05).术后随访12个月,良性病变组患者未复发71例,复发29例(其中8例患者转归为卵巢癌),复发患者HE4和CEA表达水平均显著高于未复发患者(P＜0.05),复发转归卵巢癌患者HE4和CEA表达水平均显著高于复发未转归卵巢癌患者(P＜0.05).HE4、CEA是老年慢性盆腔炎患者术后转归卵巢癌的危险因素(P＜0.001).结论 HE4和CEA高表达是老年慢性盆腔炎患者转归卵巢癌的高危因素.%Objective To analyze values of the levels of serum HE4 and CEA in assessing the risk of ovarian cancer in elderly patients with chronic pelvic inflammatory disease. Method A retrospective analysis was given to clinical datas of 174 cases which are elderly patients with chronic pelvic inflammatory disease in our hospital from January 2015 to January 2017. The patients were divided into ovarian cancer group (72 cases) and benign lesions group (102 cases) according to the results of pathological diagnosis. And 80 cases of healthy senile women were selected as control group. The expression levels of HE4 and CEA in each group were compared, and the values of the expression levels of HE4 and CEA in the prognosis of chronic pelvic inflammatory disease was evaluated by Cox regression analysis. Result The expression levels of HE4 and CEA in ovarian cancer group was significantly higher than that in benign lesions group and control group (P＜0.05). There were no significant difference in the expression levels of serum HE4 and CEA among patients with different types of ovarian cancer (P＞0.05). There were significant differences in expression levels of serum HE4 and CEA among different stages of ovarian cancer (P＜0.05). After 12 months of follow-up, 71 cases were not recurred in the benign lesions group and 29 cases recurred (8 cases were ovarian cancer). The expression levels of HE4 and CEA in recurred patients were significantly higher than those did not (P＜0.05). The expression levels of HE4 and CEA in recurred patients and those turned to ovarian cancer were significantly higher than those did not (P＜0.05), and the expression levels of HE4 and CEA in patients with ovarian cancer was significantly higher than those do not (P＜0.05). Both HE4 and CEA were risk factors of postoperative recurrence and outcome into ovarian cancer in elderly patients with chronic pelvic inflammatory disease (P＜0.001). Conclusion High expression levels of HE4 and CEA are high risk factors of recurrence and outcome into ovarian cancer in elderly patients with chronic pelvic inflammatory disease.