Li Huayan, Liao Huifeng, Jing Bilin, Wang Yifeng
Department of Gynecology, Zhujiang Hospital, Southern Medical University, Guangzhou, China.
The Second School of Clinical Medicine, Southern Medical University, Guangzhou, China.
Int J Biol Markers. 2023 Dec;38(3-4):214-222. doi: 10.1177/03936155231196253. Epub 2023 Aug 27.
Endometrial cancer is currently the prevalent malignant cancer worldwide. Diagnostic efficiency of tumor markers is limited, and coagulation function indicators in endometrial cancer are less concerned.
This study attempted to evaluate the effects of coagulation function indicators and tumor markers on the clinical diagnosis and clinicopathological characteristics of patients with endometrial cancer. The retrospective analysis compared the differences in coagulation function indicators and tumor markers among 175 patients with endometrial cancer and 170 healthy women from January 2020 to October 2022.
Compared to the healthy control, the levels of D-dimer, fibrinogen, human epididymis protein 4 (HE4), carbohydrate antigen 125 (CA125), CA153, and CA199 in patients with endometrial cancer were significantly higher ( < 0.05). Univariate and multivariate regression analyses revealed that abnormal levels of D-dimer, fibrinogen, HE4, CA125, CA153, and CA199 were related risk factors affecting the incidence of endometrial cancer. Receiver operating characteristic curve analysis exhibited that the area under the curve (0.931) and accuracy (85.2%) of combined diagnosis of coagulation function indicators (D-dimer, fibrinogen) and tumor markers (HE4, CA125, CA153, CA199) were the highest, and its sensitivity (82.3%) and specificity (88.2%) were higher than any single or combined indicators of four tumor markers. Moreover, relative expression levels of the combined indicators were significantly different among clinicopathological characteristics that had the highest predictive value in the FIGO stage ( < 0.001).
D-dimer and fibrinogen represent potential diagnostic factors for endometrial cancer. The combination of coagulation function indicators and tumor markers exhibited high diagnostic value in endometrial cancer, as well as predictive value for clinicopathological characteristics.
子宫内膜癌是目前全球流行的恶性肿瘤。肿瘤标志物的诊断效率有限,而子宫内膜癌中的凝血功能指标较少受到关注。
本研究试图评估凝血功能指标和肿瘤标志物对子宫内膜癌患者临床诊断及临床病理特征的影响。回顾性分析比较了2020年1月至2022年10月期间175例子宫内膜癌患者和170名健康女性在凝血功能指标和肿瘤标志物方面的差异。
与健康对照组相比,子宫内膜癌患者的D-二聚体、纤维蛋白原、人附睾蛋白4(HE4)、糖类抗原125(CA125)、CA153和CA199水平显著更高(<0.05)。单因素和多因素回归分析显示,D-二聚体、纤维蛋白原、HE4、CA125、CA153和CA199的异常水平是影响子宫内膜癌发病的相关危险因素。受试者工作特征曲线分析表明,凝血功能指标(D-二聚体、纤维蛋白原)和肿瘤标志物(HE4、CA125、CA153、CA199)联合诊断的曲线下面积(0.931)和准确性(85.2%)最高,其敏感性(82.3%)和特异性(88.2%)高于任何单一或四个肿瘤标志物的联合指标。此外,联合指标的相对表达水平在国际妇产科联盟(FIGO)分期中具有最高预测价值的临床病理特征之间存在显著差异(<0.001)。
D-二聚体和纤维蛋白原是子宫内膜癌的潜在诊断因素。凝血功能指标与肿瘤标志物的联合在子宫内膜癌中具有较高的诊断价值,以及对临床病理特征的预测价值。