血清SCC-Ag、CA50、CYFRA21-1水平与上皮性卵巢癌患者临床分期及预后的关系-东南大学学报医学版

血清SCC-Ag、CA50、CYFRA21-1水平与上皮性卵巢癌患者临床分期及预后的关系

单位：沧州市人民医院妇科, 河北沧州 061000

分类号：R737.31

出版年·卷·期（页码）：2024·43·第五期（691-697）

摘要：

目的: 探讨上皮性卵巢癌(EOC)患者血清鳞状细胞癌抗原(SCC-Ag)、糖链抗原50(CA50)、细胞角蛋白19片段(CYFRA21-1)水平与临床分期及预后的关系。方法: 纳入本院2018年6月至2020年10月收治的76例EOC患者为研究对象(EOC组),其中国际妇产科协会(FIGO)Ⅰ期12例、Ⅱ期24例、Ⅲ期19例、Ⅳ期21例。另选取80例体检健康者为对照组。化学发光免疫分析法测定SCC-Ag、CA50、CYFRA21-1水平。患者随访3年,分为预后不良组(死亡患者)30例与预后良好组(存活患者)46例。血清SCC-Ag、CA50、CYFRA21-1水平与临床分期的相关性采用Spearman相关分析;受试者工作特征(ROC)曲线分析血清SCC-Ag、CA50、CYFRA21-1水平对EOC患者预后的预测价值;Kaplan-Meier生存曲线分析血清SCC-Ag、CA50、CYFRA21-1表达与EOC患者预后的关系;多因素Cox回归分析患者预后不良的影响因素。结果: 与对照组相比,EOC组血清SCC-Ag、CA50、CYFRA21-1水平显著升高(P＜0.001)。随着EOC患者FIGO分期的升高,SCC-Ag、CA50、CYFRA21-1水平依次显著升高(P＜0.05)。EOC患者血清SCC-Ag、CA50、CYFRA21-1水平与FIGO分期呈正相关(P＜0.05)。预后不良组血清SCC-Ag、CA50、CYFRA21-1水平高于预后良好组(P＜0.001)。血清SCC-Ag、CA50、CYFRA21-1水平单独及联合预测EOC患者预后不良的AUC分别为0.868、0.857、0.850、0.954,且三者联合预测优于单独诊断(Z值分别为2.214、2.826、2.831,P＜0.05)。SCC-Ag、CA50、CYFRA21-1高表达患者3年生存率分别低于SCC-Ag、CA50、CYFRA21-1低表达者(Log-rank χ²值分别为21.494、21.449、16.727,P＜0.001);多因素Cox回归分析显示,SCC-Ag、CA50、CYFRA21-1是EOC患者预后不良的危险因素(P＜0.05)。结论: EOC患者血清SCC-Ag、CA50、CYFRA21-1水平升高与临床分期及预后密切相关。

Objective: To investigate the correlation between serum levels of squamous cell carcinoma antigen(SCC-Ag), carbohydrate antigen 50(CA50), cytokeratin 19 fragment(CYFRA21-1) with clinical staging and prognosis in patients with epithelial ovarian cance. Methods: From June 2018 to October 2020, 76 EOC patients accepted by our hospital were included as the study subjects(EOC group), including 12 cases of federation international of gynecology and obstetrics(FIGO) stage Ⅰ, 24 cases of stage Ⅱ, 19 cases of stage Ⅲ, and 21 cases of stage Ⅳ. Another 80 cases of healthy people with physical examination were selected as the control group. Chemiluminescence immunoassay was applied to determine the levels of SCC-Ag, CA50, and CYFRA21-1. Follow up for 3 years, and the patients were categorized into a poor prognosis group of 30 cases and a good prognosis group of 46 cases. Spearman correlation was applied to analyze the correlation between serum levels of SCC-Ag, CA50, CYFRA21-1 and clinical staging. Receiver operating characteristic(ROC) curve was applied to analyze the predictive value of serum SCC-Ag, CA50, and CYFRA21-1 levels for poor prognosis in EOC patients. Relationship between serum SCC-Ag, CA50, and CYFRA21-1 expression and prognosis of EOC patients were analyzed by Kaplan-Meier survival curves. Multivariate Cox regression was applied to analyze the influencing factors of poor prognosis in EOC patients. Results: Compared with the control group, the serum SCC-Ag, CA50, and CYFRA21-1 levels in the EOC group were obviously increased(P＜0.001). With the increase of FIGO staging in EOC patients, the levels of SCC-Ag, CA50, and CYFRA21-1 obviously increased in sequence(P＜0.05). The serum levels of SCC-Ag, CA50, and CYFRA21-1 in EOC patients were positively correlated with FIGO staging(P＜0.05). The proportion of patients with FIGO stages Ⅲ-Ⅳ and the levels of serum SCC-Ag, CA50, CYFRA21-1 in the poor prognosis group were higher than those in the good prognosis group(P＜0.001). ROC curve results showed that the AUC of poor prognosis in EOC patients predicted by serum SCC-Ag, CA50, CYFRA21-1 levels alone and in combination was 0.868, 0.857, 0.850, and 0.954, respectively, and the combined prediction of the three was better than the single diagnosis(Z=2.214, 2.826, 2.831, P＜0.05). The 3-year survival rates of patients in the SCC-Ag, CA50, CYFRA21-1 high-expression groups were lower than those in the SCC-Ag, CA50, CYFRA21-1 low-expression groups, respectively(Log-rank χ²=21.494, 21.449, 16.727, P＜0.001).The results of multivariate Cox regression analysis showed that SCC-Ag, CA50, and CYFRA21-1 were risk factors for poor prognosis in EOC patients(P＜0.05). Conclusion: Elevated levels of serum SCC-Ag, CA50, and CYFRA21-1 in EOC patients are closely related to clinical staging and prognosis.

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