血清AFP、REG4诊断子宫内膜癌的价值及其与淋巴结转移的关系-东南大学学报医学版

血清AFP、REG4诊断子宫内膜癌的价值及其与淋巴结转移的关系

单位：1. 邯郸市中心医院妇产科, 河北邯郸 056000;
2. 石家庄市中医院妇二科, 河北石家庄 050000

分类号：R737.33;R446

出版年·卷·期（页码）：2025·44·第三期（487-492）

摘要：

目的: 探讨血清甲胎蛋白(AFP)、再生胰岛衍生蛋白4(REG4)水平对子宫内膜癌(EC)诊断价值及其与淋巴结转移的关系。方法: 选取2021年1月至2023年6月期间收治的120例EC初诊患者作为EC组,根据术后病理检查淋巴结转移情况将其分为淋巴结转移组(n=68)和无淋巴结转移组(n=52);另选取同期80例子宫内膜炎患者作为良性病变组,65例体检健康者为对照组。采用酶联免疫吸附测定(ELISA)法检测血清AFP、REG4水平;分析血清AFP与REG4的相关性及二者对EC的诊断价值;多因素Logistic回归分析EC淋巴结转移的影响因素。结果: 良性病变组、EC组血清AFP、REG4水平明显高于对照组(P＜0.05),EC组血清AFP、REG4水平明显高于良性病变组(P＜0.05);血清AFP与REG4水平为正相关关系(r=0.205、P=0.025),且二者联合诊断EC的效果优于单独诊断(Z_二者联合_-AFP=4.335、P＜0.001,Z_二者联合_-REG4=2.618、P=0.009);淋巴结转移组血清AFP、REG4水平明显高于无淋巴结转移组(P＜0.05),且血清AFP、REG4水平升高为EC淋巴结转移的危险因素。结论: EC患者血清AFP、REG4水平明显升高,二者对EC具有一定的诊断价值,并与EC淋巴结转移有关。

Objective: To investigate the diagnostic value of serum alpha-fetoprotein(AFP) and regenerating islet-derived 4(REG4) levels in endometrial cancer(EC) and their relationship with lymph node metastasis. Methods: A total of 120 newly diagnosed EC patients admitted to our hospital from January 2021 to June 2023 were collected as the EC group. According to the status of lymph node metastasis, they were grouped into lymph node metastasis group(n=68) and non lymph node metastasis group(n=52). Another 80 patients with endometritis during the same period were selected as the benign lesion group, and 65 physically healthy persons were selected as the control group. ELISA was used to detect serum AFP and REG4 levels; Correlation between serum AFP and REG4 and the diagnostic value of both for EC were analyzed. Multivariate Logistic regression was applied to analyze the influencing factors of EC lymph node metastasis. Results: The serum AFP and REG4 levels were significantly higher in the benign lesion and EC groups than those in the control group(P<0.05), and serum AFP and REG4 levels were significantly higher in the EC group than those in the benign lesion group(P<0.05). Serum AFP and REG4 levels were positively correlated(r=0.205, P=0.025), and the combination of the two was more effective in diagnosing EC than the diagnosis alone(Z_{combination-AFP}=4.335, P<0.001, Z_{combination-REG4}=2.618, P=0.009). The serum AFP and REG4 levels in the lymph node metastasis group were significantly higher than those in the non lymph node metastasis group(P<0.05), and elevated serum AFP and REG4 levels were risk factors for EC lymph node metastasis. Conclusion: Serum AFP and REG4 levels were significantly elevated in EC patients, both of which have some diagnostic value for EC and are associated with EC lymph node metastasis.

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