探討人乳頭狀病毒（HPV）與五種腫瘤標(biāo)志物聯(lián)合檢測(cè)在宮頸癌早期診斷中的價(jià)值
發(fā)布時(shí)間：2018-08-11 10:59
【摘要】：目的:探討HPV及AFP、CEA、CA199、CA125、SCC五種腫瘤標(biāo)志物聯(lián)合檢測(cè)在宮頸癌早期診斷中的價(jià)值。方法:對(duì)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(shí)時(shí)熒光定量PCR方法對(duì)宮頸分泌物中HPV進(jìn)行檢測(cè),利用電化學(xué)發(fā)光免疫分析儀分別檢測(cè)血清中AFP、CEA、CA199、CA125含量,利用微粒子酶免分析法檢測(cè)血清中SCC含量;統(tǒng)計(jì)學(xué)方法采用SPSS19.0統(tǒng)計(jì)學(xué)處理軟件進(jìn)行數(shù)據(jù)分析,計(jì)量資料用(?)±s表示,組間比較采用t檢驗(yàn);計(jì)數(shù)資料用率表示,組間比較采用χ2檢驗(yàn);采用受試者工作曲線(ROC曲線)來評(píng)價(jià)AFP、CEA、CA199、CA125、SCC對(duì)宮頸癌診斷的價(jià)值。結(jié)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(jì)學(xué)意義(p0.001)。3.本次研究表明各個(gè)年齡組HPV感染陽性率不完全相同,差異有統(tǒng)計(jì)學(xué)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(jì)學(xué)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(jì)學(xué)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(duì)照組(P0.001),差異有統(tǒng)計(jì)學(xué)意義;宮頸癌前病變組CEA、CA125、CA199、SCC顯著高于正常對(duì)照組(P0.001),差異有統(tǒng)計(jì)學(xué)意義;宮頸癌前病變組與正常對(duì)照組AFP比較無統(tǒng)計(jì)學(xué)差異(P0.05)。7.對(duì)宮頸癌組及正常對(duì)照組的個(gè)體進(jìn)行AFP、CEA、CA125、CA199、SCC水平的檢測(cè),并分析單項(xiàng)、雙項(xiàng)、三項(xiàng)、四項(xiàng)及五項(xiàng)聯(lián)合檢測(cè)對(duì)宮頸癌的診斷的價(jià)值,發(fā)現(xiàn)五項(xiàng)聯(lián)合檢測(cè)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(biāo)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(cè)敏感性高于單一檢測(cè)HPV及單一檢測(cè)五種腫瘤標(biāo)志物。結(jié)論:HPV與五種腫瘤標(biāo)志物聯(lián)合檢測(cè)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(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.33
本文編號(hào)：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(xué)位授予單位】：天津醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R737.33
【參考文獻(xiàn)】
相關(guān)期刊論文 前3條
1 汪曉峰;魏仙風(fēng);唐春妍;;宮頸癌患者血清中腫瘤標(biāo)志物檢測(cè)的臨床分析[J];中國(guó)衛(wèi)生檢驗(yàn)雜志;2017年01期
2 段山紅;安瑞芳;;HPV感染亞型分布及其與宮頸病變關(guān)系的研究[J];中國(guó)婦幼健康研究;2015年05期
3 丁洪慧;劉暉;梁美蓉;曾四元;;鱗狀細(xì)胞癌抗原在宮頸癌中的臨床應(yīng)用[J];中國(guó)婦幼保健;2009年26期
，本文編號(hào)：2176801
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