卵巢子宫内膜异位症患者BDNF、CA125水平检测及其诊断价值分析
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摘要
目的探究卵巢子宫内膜异位症患者的脑源性神经营养因子(BDNF)、糖类抗原125(CA125)水平变化及其诊断价值。方法选择2017年2月～2018年6月中国石油天然气总公司中心医院(以下简称"我院")妇产科收治的78例卵巢子宫内膜异位症(EMs)患者作为EMs组,另选择同期在我院进行常规体检的50例健康女性作为对照组。比较两组患者以及不同r-AFS病理分期患者的BDNF表达情况及血清CA125水平,分析卵巢EMs发病、r-AFS病理分期与BDNF表达、血清CA125水平的相关性,计算BDNF、CA125单项检测以及联合检测在诊断卵巢EMs中的诊断效能。结果 EMs组患者的BDNF表达及血清CA125水平均明显高于对照组(P <0.05)。不同r-AFS病理分期患者的BDNF表达及血清CA125水平存在显著差异(P <0.05),BDNF表达、血清CA125水平随着r-AFS病理分期的增高而明显升高。BDNF表达及血清CA125水平与卵巢EMs发病、r-AFS病理分期均呈明显正相关性(P <0.05)。BDNF、CA125联合检测诊断卵巢EMs的敏感度、特异度和准确率分别为98.72%、100.00%和99.22%,明显高于BDNF、CA125单项检测(r> 0.7,P <0.05)。结论 BDNF表达及血清CA125水平的异常升高与卵巢EMs的发生、发展密切相关,BDNF、CA125水平联合检测有助于卵巢EMs的分期诊断和病情评估。
Objective To investigate the changes of brain-derived neurotrophic factor(BDNF) and carbohydrate antigen 125(CA125) levels in patients with ovarian endometriosis and their diagnostic value. Methods From February 2017 to June 2018, 78 patients with ovarian endometriosis(EMs) admitted to the Department of Obstetrics and Gynecology,China National Petroleum Corporation Central Hospital( "our hospital" for short) were selected as the EMs group. A total of 50 healthy women who underwent routine physical examination in our hospital during the same period were selected as the control group. The expression of BDNF and serum CA125 levels in two groups of patients and the patients with different r-AFS pathological stages were compared. The correlations between the onset and stage of ovarian EMs and the expression of BDNF and the level of serum CA125 were analyzed. The diagnostic efficacy of BDNF, CA125 and combined detection in the diagnosis of ovarian EMs were calculated. Results The expression of BDNF and serum CA125 in patients with EMs were significantly higher than those in the control group(P < 0.05). There were significant differences in BDNF expression and serum CA125 levels between patients with different r-AFS pathological stages(P <0.05). BDNF expression and serum CA125 levels were significantly increased with the increase of r-AFS pathological stage(P < 0.05). BDNF expression and serum CA125 levels were positively correlated with ovarian EMs and r-AFS pathological stage(P < 0.05). The sensitivity, specificity and accuracy of combined detection of BDNF and CA125 in diagnosis of ovarian EMs were 98.72%, 100.00% and 99.22% respectively, which were significantly higher than those of single detection of BDNF and CA125(r > 0.7, P < 0.05). Conclusion The abnormal increase of BDNF expression and serum CA125 level are closely related to the occurrence and development of ovarian EMs. The combined detection of BDNF and CA125 level is helpful to the staging diagnosis and evaluation of ovarian EMs.
Objective To investigate the changes of brain-derived neurotrophic factor(BDNF) and carbohydrate antigen 125(CA125) levels in patients with ovarian endometriosis and their diagnostic value. Methods From February 2017 to June 2018, 78 patients with ovarian endometriosis(EMs) admitted to the Department of Obstetrics and Gynecology,China National Petroleum Corporation Central Hospital( "our hospital" for short) were selected as the EMs group. A total of 50 healthy women who underwent routine physical examination in our hospital during the same period were selected as the control group. The expression of BDNF and serum CA125 levels in two groups of patients and the patients with different r-AFS pathological stages were compared. The correlations between the onset and stage of ovarian EMs and the expression of BDNF and the level of serum CA125 were analyzed. The diagnostic efficacy of BDNF, CA125 and combined detection in the diagnosis of ovarian EMs were calculated. Results The expression of BDNF and serum CA125 in patients with EMs were significantly higher than those in the control group(P < 0.05). There were significant differences in BDNF expression and serum CA125 levels between patients with different r-AFS pathological stages(P <0.05). BDNF expression and serum CA125 levels were significantly increased with the increase of r-AFS pathological stage(P < 0.05). BDNF expression and serum CA125 levels were positively correlated with ovarian EMs and r-AFS pathological stage(P < 0.05). The sensitivity, specificity and accuracy of combined detection of BDNF and CA125 in diagnosis of ovarian EMs were 98.72%, 100.00% and 99.22% respectively, which were significantly higher than those of single detection of BDNF and CA125(r > 0.7, P < 0.05). Conclusion The abnormal increase of BDNF expression and serum CA125 level are closely related to the occurrence and development of ovarian EMs. The combined detection of BDNF and CA125 level is helpful to the staging diagnosis and evaluation of ovarian EMs.
引文
[1]倪琴,秦萌,张凤格,等.卵巢子宫内膜异位症恶变25例临床病理及预后分析[J].现代妇产科进展,2018,27(5):369-371.
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[10]Vetvicka V,LaganàAS,Salmeri FM,et al.Regulation o apoptotic pathways during endometriosis:from the molecular basis to the future perspectives[J].Arch Gyneco Obstet,2016,294(5):897-904.
[11]姚金翠,刘巧玲.子宫内膜异位症患者血清糖类抗原-125、人附睾分泌蛋白4、糖类抗原-199表达情况及其临床意义分析[J].中国妇幼保健,2017,32(12):2608-2610.
[12]路士芬.CA125诊断子宫内膜异位症的意义及相关因素分析[J].标记免疫分析与临床,2015,22(7):654-656,659.
[13]郭新颖,郭华峰.EMT合并不孕患者AcrAb、Sp17Ab、CA125水平与术后妊娠结局的关系[J].实验与检验医学,2018,36(3):437-439,442.
[14]Hirsch M,Duffy JM,Kusznir JO,et al.Variation in outcome reporting in endometriosis trials:a systematic review[J].Am J Obstet Gynecol,2016,214(4):452-464.
[15]王芸,闻姬,方舟,等.BDNF基因的Val66Met多态性与子宫内膜异位症性不孕的相关性及对IVF-ET助孕结局的影响[J].国际生殖健康/计划生育杂志,2018,37(1):10-14.
[16]凌华萍,仝进毅.超声、癌胚抗原125和人附睾分泌蛋白4在卵巢癌和卵巢子宫内膜异位囊肿鉴别诊断中的价值[J].中国妇幼保健,2017,32(22):5517-5519.
[17]刘云鹭,李维丽,刘萍,等.脑源性神经营养因子及其受体P75在ⅠB1~ⅡB期宫颈鳞癌和正常宫颈组织中的表达[J].中国实用妇科与产科杂志,2017,33(2):200-204.
[18]Wessels JM,Kay VR,Leyland NA,et al.Assessing brainderived neurotrophic factor as a novel clinical marker of endometriosis[J].Fertil Steril,2016,105(1):119-128.
[19]高淑平,柯琼浪,谭天照.CA125及ROMA在阳春地区子宫内膜异位症患者风险评估中的应用研究[J].国际检验医学杂志,2017,38(24):3420-3423.
[20]王晓贤.联合检测血清HE4、CEA、CA125在卵巢癌诊断及治疗中的意义[J].中国医药科学,2018,8(23):75-78.
[21]龙平,洛若愚.腹腔镜联合醋酸亮丙瑞林治疗子宫内膜异位症合并不孕的临床效果[J].中国医药导报,2017,14(26):76-78,82.
[22]Baggio S,Zecchin A,Pomini P,et al.The Role of Computed Tomography Colonography in Detecting Bowel Involvement in Women With Deep Infiltrating Endometriosis:Comparison With Clinical History,Serum Ca125,and Transvaginal Sonography[J].Comput Assist Tomogr,2016,40(6):886-891.
[23]黄蓉,王玲,邓宇傲,等.子宫内膜异位症患者子宫内膜PDGF、LN表达及其与血清CA_(125)水平相关性研究[J].实用妇产科杂志,2016,32(2):113-116.
[24]刘树皖,杨修军.HE4、CA125及血浆Fbg联合检测在卵巢癌患者早期诊断中的临床价值[J].中国现代医生,2017,55(36):131-133.
[25]陈红.血浆溶血磷脂酸及CA125与子宫内膜癌临床病理特征之间的关系分析[J].中国医药科学,2017,7(22):47-50.
[2]Karimi-Zarchi M,Dehshiri-Zadeh N,Sekhavat L,et al Correlation of CA-125 serum level and clinico-pathological characteristic of patients with endometriosis[J].Int JReprod Biomed(Yazd),2016,14(11):713-718.
[3]陈惠娴,张真真,万贵平.子宫内膜异位患者CXCL16的表达情况及诊断价值[J].中国医药导报,2018,15(15):92-95.
[4]温丽,郭珍,常春红,等.子宫内膜异位症患者血清和腹腔液中VEGF、IL-6、TNF-α、CA125表达及临床意义[J]现代中西医结合杂志,2017,26(5):467-470.
[5]韩玉双,徐伟,徐延明.血清CA125、TIMP-1及EMAb在子宫内膜异位症诊断中的价值[J].中国妇幼保健,2018,33(12):2657-2659.
[6]中华医学会妇产科学分会子宫内膜异位症协作组.子宫内膜异位症的诊治指南[J].中华妇产科杂志,2015,50(3):161-169.
[7]洪玮,段华,汪沙,等.BDNF及TrKB在子宫内膜异位症在位内膜和异位病灶组织中的表达及意义[J].中国计划生育和妇产科,2018,10(3):32-36.
[8]Rocha AL,Vieira EL,Ferreira MC,et al.Plasma brainderived neurotrophic factor in women with p8elvic pain:a potential biomarker for endometriosis?[J]Biomark Med,2017,11(4):313-317.
[9]汤礼宾,章志福,麦丽兰.血清CA125、VEGF、MCP-1在子宫内膜异位症诊断中的应用价值[J].临床和实验医学杂志,2018,17(10):1085-1088.
[10]Vetvicka V,LaganàAS,Salmeri FM,et al.Regulation o apoptotic pathways during endometriosis:from the molecular basis to the future perspectives[J].Arch Gyneco Obstet,2016,294(5):897-904.
[11]姚金翠,刘巧玲.子宫内膜异位症患者血清糖类抗原-125、人附睾分泌蛋白4、糖类抗原-199表达情况及其临床意义分析[J].中国妇幼保健,2017,32(12):2608-2610.
[12]路士芬.CA125诊断子宫内膜异位症的意义及相关因素分析[J].标记免疫分析与临床,2015,22(7):654-656,659.
[13]郭新颖,郭华峰.EMT合并不孕患者AcrAb、Sp17Ab、CA125水平与术后妊娠结局的关系[J].实验与检验医学,2018,36(3):437-439,442.
[14]Hirsch M,Duffy JM,Kusznir JO,et al.Variation in outcome reporting in endometriosis trials:a systematic review[J].Am J Obstet Gynecol,2016,214(4):452-464.
[15]王芸,闻姬,方舟,等.BDNF基因的Val66Met多态性与子宫内膜异位症性不孕的相关性及对IVF-ET助孕结局的影响[J].国际生殖健康/计划生育杂志,2018,37(1):10-14.
[16]凌华萍,仝进毅.超声、癌胚抗原125和人附睾分泌蛋白4在卵巢癌和卵巢子宫内膜异位囊肿鉴别诊断中的价值[J].中国妇幼保健,2017,32(22):5517-5519.
[17]刘云鹭,李维丽,刘萍,等.脑源性神经营养因子及其受体P75在ⅠB1~ⅡB期宫颈鳞癌和正常宫颈组织中的表达[J].中国实用妇科与产科杂志,2017,33(2):200-204.
[18]Wessels JM,Kay VR,Leyland NA,et al.Assessing brainderived neurotrophic factor as a novel clinical marker of endometriosis[J].Fertil Steril,2016,105(1):119-128.
[19]高淑平,柯琼浪,谭天照.CA125及ROMA在阳春地区子宫内膜异位症患者风险评估中的应用研究[J].国际检验医学杂志,2017,38(24):3420-3423.
[20]王晓贤.联合检测血清HE4、CEA、CA125在卵巢癌诊断及治疗中的意义[J].中国医药科学,2018,8(23):75-78.
[21]龙平,洛若愚.腹腔镜联合醋酸亮丙瑞林治疗子宫内膜异位症合并不孕的临床效果[J].中国医药导报,2017,14(26):76-78,82.
[22]Baggio S,Zecchin A,Pomini P,et al.The Role of Computed Tomography Colonography in Detecting Bowel Involvement in Women With Deep Infiltrating Endometriosis:Comparison With Clinical History,Serum Ca125,and Transvaginal Sonography[J].Comput Assist Tomogr,2016,40(6):886-891.
[23]黄蓉,王玲,邓宇傲,等.子宫内膜异位症患者子宫内膜PDGF、LN表达及其与血清CA_(125)水平相关性研究[J].实用妇产科杂志,2016,32(2):113-116.
[24]刘树皖,杨修军.HE4、CA125及血浆Fbg联合检测在卵巢癌患者早期诊断中的临床价值[J].中国现代医生,2017,55(36):131-133.
[25]陈红.血浆溶血磷脂酸及CA125与子宫内膜癌临床病理特征之间的关系分析[J].中国医药科学,2017,7(22):47-50.