Department of Obstetrics and Gynecology, Hallym University Dongtan Sacred Heart Hospital, Kyeonggido, South Korea.
Med Sci Monit. 2019 Feb 9;25:1087-1092. doi: 10.12659/MSM.912787.
BACKGROUND This study evaluated the performance of serum CYFRA 21-1 and placental growth factor (PIGF) as screening markers for endometriosis. MATERIAL AND METHODS In this prospective study included 81 female patients who underwent laparoscopy to treat benign ovarian tumors. Serum samples were obtained from all study patients before surgery. Serum marker levels, including CYFRA 21-1, PIGF, cancer antigen (CA)125, CA19-9, and human epididymis protein 4 (HE4) were measured using a fluorescence immunoassay technique. RESULTS Forty of the patients were diagnosed with endometriosis (the study group) and 41 women were diagnosed with other benign ovarian tumors (the control group). Mean serum CYFRA 21-1 and PIGF levels were not different between these 2 groups (P=0.179 and P=0.865, respectively). Elevated serum CA125 levels (>35 U/mL) and lower CYFRA 21-1 levels (≤2.29 ng/mL) were more frequently observed in the endometriosis study group than in the control group (P<0.0001, and P=048, respectively). High serum PIGF levels (>14.2 pg/mL) were observed in both groups (P=0.226). Mean serum CA19-9 levels and HE4 levels, as well as the ROMA (risk of ovarian malignancy Algorithm) score were similar between the 2 groups. Sensitivity (95.0%) and negative predictive value (NPV) (80.0%) of CYFRA 21-1 for diagnosing endometriosis were higher than those of CA125 (sensitivity 67.5%, NPV 74.5%) and PIGF (sensitivity 20.0%, NPV 53.6%). However, the specificity (PIGF 90.2%, CA125 92.7%) and positive predictive value (PPV) (PIGF 66.7%, CA125 87.1%) of PIGF and CA125 for diagnosing endometriosis were higher than those of CYFRA 21-1 (specificity 19.5%, PPV 53.5%). CONCLUSIONS CYFRA 21-1 and PIGF may be promising markers to identify patients with and without ovarian endometriosis.
本研究评估了血清细胞角蛋白 19 片段 21-1(CYFRA 21-1)和胎盘生长因子(PIGF)作为子宫内膜异位症筛查标志物的性能。
本前瞻性研究纳入了 81 名因良性卵巢肿瘤而行腹腔镜手术治疗的女性患者。所有研究患者均在术前采集血清样本。采用荧光免疫分析技术检测血清标志物水平,包括 CYFRA 21-1、PIGF、癌抗原 125(CA125)、CA19-9 和人附睾蛋白 4(HE4)。
40 名患者被诊断为子宫内膜异位症(研究组),41 名女性被诊断为其他良性卵巢肿瘤(对照组)。这两组患者的血清 CYFRA 21-1 和 PIGF 水平无差异(P=0.179 和 P=0.865)。与对照组相比,子宫内膜异位症研究组患者的血清 CA125 水平升高(>35 U/mL)和 CYFRA 21-1 水平降低(≤2.29ng/mL)更为常见(P<0.0001 和 P=0.48)。两组患者的血清 PIGF 水平均较高(P=0.226)。两组患者的血清 CA19-9 水平和 HE4 水平以及卵巢恶性肿瘤风险算法(ROMA)评分相似。CYFRA 21-1 诊断子宫内膜异位症的敏感性(95.0%)和阴性预测值(NPV)(80.0%)高于 CA125(敏感性 67.5%,NPV 74.5%)和 PIGF(敏感性 20.0%,NPV 53.6%)。然而,PIGF 和 CA125 诊断子宫内膜异位症的特异性(PIGF 90.2%,CA125 92.7%)和阳性预测值(PPV)(PIGF 66.7%,CA125 87.1%)均高于 CYFRA 21-1(特异性 19.5%,PPV 53.5%)。
CYFRA 21-1 和 PIGF 可能是识别卵巢子宫内膜异位症患者和非患者的有前途的标志物。