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生存素和血管内皮生长因子作为子宫内膜异位症诊断中的新型生物标志物

Survivin and VEGF as Novel Biomarkers in Diagnosis of Endometriosis.

作者信息

Acimovic Milena, Vidakovic Snezana, Milic Natasa, Jeremic Katarina, Markovic Milos, Milosevic-Djeric Ana, Lazovic-Radonjic Gordana

机构信息

Department of Gynecology and Obstetrics, Medical Center Uzice, Serbia.

Institute for Gynecology and Obstetrics, Clinical Center, Belgrade, Serbia.

出版信息

J Med Biochem. 2016 Jan;35(1):63-68. doi: 10.1515/jomb-2015-0005. Epub 2015 Dec 30.

Abstract

BACKGROUND

The aim of this study was to investigate the role of peripheral blood markers as additional diagnostic tools to transvaginal ultrasound (TVU) findings in the diagnosis of endometriosis.

METHODS

This study included 40 patients undergoing laparoscopy for suspected endometriosis from January to December 2012. Preoperative levels of serum CA125, CA19-9, CEA and mRNA expression levels for survivin and VEGF were obtained. Real-time PCR was used to determine relative gene expression. A new diagnostic score was obtained by deploying the peripheral blood markers to the TVU findings. Statistical methods used were Chi-square, Fisher's, Student's t-test or the Mann - Whitney test.

RESULTS

There was a statistically significant difference in serum CA125, survivin and VEGF levels in patients with endometriosis and those without endometriosis (p<0.001, p=0.025 and p=0.009, respectively). False negative TVU findings were noted in 3/13 patients (23.1%) with peritoneal endometriosis without ovaries involvement. High sensitivity (93.3%), specificity (90.0%), PPV (96.6%), NPV (81.8%) and accuracy (92.5%) were obtained for a diagnostic score based on TVU and significant peripheral blood markers (CA125, survivin and VEGF).

CONCLUSIONS

Determination of serum CA125, mRNA expression levels for survivin and VEGF along with TVU can contribute to higher accuracy of the noninvasive diagnostic tools for endometriosis.

摘要

背景

本研究旨在探讨外周血标志物作为经阴道超声(TVU)检查结果之外的辅助诊断工具在子宫内膜异位症诊断中的作用。

方法

本研究纳入了2012年1月至12月间因疑似子宫内膜异位症而接受腹腔镜检查的40例患者。获取术前血清CA125、CA19 - 9、CEA水平以及生存素和血管内皮生长因子(VEGF)的mRNA表达水平。采用实时聚合酶链反应(PCR)测定相对基因表达。通过将外周血标志物应用于TVU检查结果得出一个新的诊断评分。所采用的统计方法包括卡方检验、费舍尔检验、学生t检验或曼 - 惠特尼检验。

结果

子宫内膜异位症患者与非子宫内膜异位症患者的血清CA125、生存素和VEGF水平存在统计学显著差异(分别为p<(0.001)、p = (0.025)和p = (0.009))。在13例无卵巢受累的腹膜子宫内膜异位症患者中,有3例(23.1%)TVU检查结果为假阴性。基于TVU和显著的外周血标志物(CA125、生存素和VEGF)得出的诊断评分具有高灵敏度(93.3%)、特异性(90.0%)、阳性预测值(96.6%)、阴性预测值(81.8%)和准确性(92.5%)。

结论

测定血清CA125、生存素和VEGF的mRNA表达水平并结合TVU检查,有助于提高子宫内膜异位症无创诊断工具的准确性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ca9d/5346803/06df0dbc1812/jomb-35-063-g001.jpg

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