探討人乳頭狀病毒（HPV）與五種腫瘤標志物聯(lián)合檢測在宮頸癌早期診斷中的價值
發(fā)布時間：2018-08-11 10:59
【摘要】：目的:探討HPV及AFP、CEA、CA199、CA125、SCC五種腫瘤標志物聯(lián)合檢測在宮頸癌早期診斷中的價值。方法:對本院2014年1月到2016年12月健康體檢者124例,宮頸炎患者200例,以及本院此期間住院治療的宮頸癌前病變患者59例以及宮頸癌患者32例,利用實時熒光定量PCR方法對宮頸分泌物中HPV進行檢測,利用電化學發(fā)光免疫分析儀分別檢測血清中AFP、CEA、CA199、CA125含量,利用微粒子酶免分析法檢測血清中SCC含量;統(tǒng)計學方法采用SPSS19.0統(tǒng)計學處理軟件進行數(shù)據(jù)分析,計量資料用(?)±s表示,組間比較采用t檢驗;計數(shù)資料用率表示,組間比較采用χ2檢驗;采用受試者工作曲線(ROC曲線)來評價AFP、CEA、CA199、CA125、SCC對宮頸癌診斷的價值。結果:1.本次研究共檢出HPV亞型17種,其中檢出率最高的HPV亞型為HPV16。2.本次研究表明宮頸癌前病變組、宮頸癌組HPV16檢出率高于健康查體組和宮頸炎組,差異有統(tǒng)計學意義(p0.001)。3.本次研究表明各個年齡組HPV感染陽性率不完全相同,差異有統(tǒng)計學意義(p0.01)。4.宮頸癌組HPV檢出陽性率明顯高于健康查體、宮頸炎、癌前病變組,差異有統(tǒng)計學意意義(p0.001);癌前病變組明顯高于宮頸炎組和健康查體組,差異有統(tǒng)計學意義(p0.001)。5.本次研究所有入選415人中共檢出HPV單一感染115例,二重感染34例,多重感染3例,其中以HPV52型合并感染最常見,HPV感染仍然以單一亞型感染為主,多重感染僅占一小部分。6.宮頸癌組的AFP、CEA、CA125、CA199、SCC顯著高于宮頸癌前病變組和正常對照組(P0.001),差異有統(tǒng)計學意義;宮頸癌前病變組CEA、CA125、CA199、SCC顯著高于正常對照組(P0.001),差異有統(tǒng)計學意義;宮頸癌前病變組與正常對照組AFP比較無統(tǒng)計學差異(P0.05)。7.對宮頸癌組及正常對照組的個體進行AFP、CEA、CA125、CA199、SCC水平的檢測,并分析單項、雙項、三項、四項及五項聯(lián)合檢測對宮頸癌的診斷的價值,發(fā)現(xiàn)五項聯(lián)合檢測診斷的敏感性最高,與其他診斷方式相比有顯著性差異(p0.05)。8.五種血清腫瘤標志物ROC曲線分析在宮頸癌的診斷中SCC曲線下面積比AFP、CEA、CA199、CA125更大,在宮頸癌診斷中具有較高的敏感性。其次為CA125。9.HPV及AFP、CEA、CA125、CA199、SCC聯(lián)合檢測敏感性高于單一檢測HPV及單一檢測五種腫瘤標志物。結論:HPV與五種腫瘤標志物聯(lián)合檢測可用于宮頸癌的早期診斷。
[Abstract]:Objective: to evaluate the value of combined detection of five tumor markers (HPV and AFPCEA CA125C) in early diagnosis of cervical cancer. Methods: from January 2014 to December 2016, 124 patients with cervical cancer, 200 patients with cervicitis, 59 patients with cervical precancerous lesions and 32 patients with cervical cancer were enrolled in our hospital. The HPV in cervical secretions was detected by real-time fluorescence quantitative PCR method. The content of SCC in serum was detected by electrochemiluminescence immunoassay (ECLIA) and microparticle enzyme immunoassay (PIA). SPSS19.0 software was used to analyze the data, the measurement data were expressed as (?) 鹵s, and the t test was used for the comparison between groups, the rate of data used was expressed, the 蠂 2 test was used for the comparison between groups. The ROC curve was used to evaluate the value of ROC in the diagnosis of cervical cancer. The result is 1: 1. In this study, 17 HPV subtypes were detected, and the highest detection rate of HPV subtype was HPV16.2. This study showed that the positive rate of HPV16 in precancerous lesion group and cervical cancer group was higher than that in healthy check-up group and cervicitis group, the difference was statistically significant (p0. 001). 3. This study shows that the positive rate of HPV infection in all age groups is not exactly the same, the difference is statistically significant (p0.01). 4. The positive rate of HPV in cervical cancer group was significantly higher than that in healthy examination group, cervicitis group and precancerous lesion group (p0. 001), and the positive rate in precancerous lesion group was significantly higher than that in cervicitis group and healthy examination group (p0. 001). In this study, 115 cases of HPV single infection, 34 cases of double infection and 3 cases of multiple infection were detected in 415 subjects. Among them, the most common infection of HPV52 type co-infection was still single subtype infection, and multiple infection accounted for only a small part. The SCC of the cervical cancer group was significantly higher than that of the precancerous lesion group and the normal control group (P0.001), and the SCC of the cervical precancerous lesion group was significantly higher than that of the normal control group (P0.001), and the SCC of the cervical cancer group was significantly higher than that of the normal control group (P0.001). There was no significant difference in AFP between precancerous lesion group and normal control group (P0.05). The level of SCC in cervical cancer group and normal control group was detected by AFPG-CEACA125CA1999.The value of single, double, three, four and five combined tests in the diagnosis of cervical cancer was analyzed. The results showed that five combined tests were the most sensitive in the diagnosis of cervical cancer. Compared with other diagnostic methods, there was significant difference (p0.05). In the diagnosis of cervical cancer, the area under the SCC curve was larger than that of the AFP-CEACA199CA199CA125, and had a higher sensitivity in the diagnosis of cervical cancer by ROC curve analysis of five serum tumor markers. The sensitivity of combined detection of CA125.9.HPV and AFPCEA CA125 CA199C was higher than that of single detection of HPV and single detection of five tumor markers. Conclusion the combined detection of human papillomavirus (HPV) and five tumor markers can be used for early diagnosis of cervical cancer.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R737.33
本文編號：2176801
[Abstract]:Objective: to evaluate the value of combined detection of five tumor markers (HPV and AFPCEA CA125C) in early diagnosis of cervical cancer. Methods: from January 2014 to December 2016, 124 patients with cervical cancer, 200 patients with cervicitis, 59 patients with cervical precancerous lesions and 32 patients with cervical cancer were enrolled in our hospital. The HPV in cervical secretions was detected by real-time fluorescence quantitative PCR method. The content of SCC in serum was detected by electrochemiluminescence immunoassay (ECLIA) and microparticle enzyme immunoassay (PIA). SPSS19.0 software was used to analyze the data, the measurement data were expressed as (?) 鹵s, and the t test was used for the comparison between groups, the rate of data used was expressed, the 蠂 2 test was used for the comparison between groups. The ROC curve was used to evaluate the value of ROC in the diagnosis of cervical cancer. The result is 1: 1. In this study, 17 HPV subtypes were detected, and the highest detection rate of HPV subtype was HPV16.2. This study showed that the positive rate of HPV16 in precancerous lesion group and cervical cancer group was higher than that in healthy check-up group and cervicitis group, the difference was statistically significant (p0. 001). 3. This study shows that the positive rate of HPV infection in all age groups is not exactly the same, the difference is statistically significant (p0.01). 4. The positive rate of HPV in cervical cancer group was significantly higher than that in healthy examination group, cervicitis group and precancerous lesion group (p0. 001), and the positive rate in precancerous lesion group was significantly higher than that in cervicitis group and healthy examination group (p0. 001). In this study, 115 cases of HPV single infection, 34 cases of double infection and 3 cases of multiple infection were detected in 415 subjects. Among them, the most common infection of HPV52 type co-infection was still single subtype infection, and multiple infection accounted for only a small part. The SCC of the cervical cancer group was significantly higher than that of the precancerous lesion group and the normal control group (P0.001), and the SCC of the cervical precancerous lesion group was significantly higher than that of the normal control group (P0.001), and the SCC of the cervical cancer group was significantly higher than that of the normal control group (P0.001). There was no significant difference in AFP between precancerous lesion group and normal control group (P0.05). The level of SCC in cervical cancer group and normal control group was detected by AFPG-CEACA125CA1999.The value of single, double, three, four and five combined tests in the diagnosis of cervical cancer was analyzed. The results showed that five combined tests were the most sensitive in the diagnosis of cervical cancer. Compared with other diagnostic methods, there was significant difference (p0.05). In the diagnosis of cervical cancer, the area under the SCC curve was larger than that of the AFP-CEACA199CA199CA125, and had a higher sensitivity in the diagnosis of cervical cancer by ROC curve analysis of five serum tumor markers. The sensitivity of combined detection of CA125.9.HPV and AFPCEA CA125 CA199C was higher than that of single detection of HPV and single detection of five tumor markers. Conclusion the combined detection of human papillomavirus (HPV) and five tumor markers can be used for early diagnosis of cervical cancer.
【學位授予單位】：天津醫(yī)科大學
【學位級別】：碩士
【學位授予年份】：2017
【分類號】：R737.33
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