CAJ | 학술논문

目的：探讨血清人附睾分泌蛋白4（HE4）和血管内皮生长因子（VEGF）联合预测卵巢癌疾病临床转归的价值。方法：选取2008年1月至2009年12月期间本院收治的卵巢癌患者48例作为观察组，另选取30例同期同龄健康志愿者作为对照。采用 ELISA 法检测两组血清 HE4和 VEGF 水平。卵巢癌患者均根据病情进行手术治疗，并于术后1、3、5、7和10 d 复查以上项目。统计患者5年内复发情况和无疾病进展生存期（DFS）等临床转归情况、比较不同临床转归情况患者的血清 HE4和 VEGF 水平并采用 ROC曲线分析卵巢癌患者血清 HE4和 VEGF 水平联合预测其临床转归情况的价值。结果：与对照组比较，观察组术前血清 HE4和 VEGF 水平均明显升高（P﹤0.05）；与术前比较，观察组术后7、10 d 的血清 HE4和VEGF 水平显著降低（P﹤0.05）。观察组复发率为60.42%，平均 DFS 为（3.11±1.69）年。与未复发患者和DFS 长于平均值患者比较，复发患者和 DFS 短于平均值患者术前和术后血清 HE4和 VEGF 水平均升高，差异有统计学意义（P﹤0.05）。血清 HE4和 VEGF 水平联合预测卵巢癌复发和 DFS 的 ROC 曲线下面积、敏感度、特异度和准确性均高于血清 HE4水平或血清 VEGF 水平单独预测卵巢癌临床转归情况。结论：卵巢癌患者血清 HE4和 VEGF 水平较高，血清 HE4和 VEGF 水平联合预测卵巢癌疾病临床转归的准确性高，出现血清 HE4和 VEGF 水平升高的卵巢癌患者需警惕其不良临床转归情况的出现并及时干预以改善患者疾病临床转归。
목적：탐토혈청인부고분비단백4（HE4）화혈관내피생장인자（VEGF）연합예측란소암질병림상전귀적개치。방법：선취2008년1월지2009년12월기간본원수치적란소암환자48례작위관찰조，령선취30례동기동령건강지원자작위대조。채용 ELISA 법검측량조혈청 HE4화 VEGF 수평。란소암환자균근거병정진행수술치료，병우술후1、3、5、7화10 d 복사이상항목。통계환자5년내복발정황화무질병진전생존기（DFS）등림상전귀정황、비교불동림상전귀정황환자적혈청 HE4화 VEGF 수평병채용 ROC곡선분석란소암환자혈청 HE4화 VEGF 수평연합예측기림상전귀정황적개치。결과：여대조조비교，관찰조술전혈청 HE4화 VEGF 수평균명현승고（P﹤0.05）；여술전비교，관찰조술후7、10 d 적혈청 HE4화VEGF 수평현저강저（P﹤0.05）。관찰조복발솔위60.42%，평균 DFS 위（3.11±1.69）년。여미복발환자화DFS 장우평균치환자비교，복발환자화 DFS 단우평균치환자술전화술후혈청 HE4화 VEGF 수평균승고，차이유통계학의의（P﹤0.05）。혈청 HE4화 VEGF 수평연합예측란소암복발화 DFS 적 ROC 곡선하면적、민감도、특이도화준학성균고우혈청 HE4수평혹혈청 VEGF 수평단독예측란소암림상전귀정황。결론：란소암환자혈청 HE4화 VEGF 수평교고，혈청 HE4화 VEGF 수평연합예측란소암질병림상전귀적준학성고，출현혈청 HE4화 VEGF 수평승고적란소암환자수경척기불량림상전귀정황적출현병급시간예이개선환자질병림상전귀。
Objective:To investigate the prediction value of serum human epididymis secretory protein 4 (HE4)and vascular endothelial growth factor(VEGF)on clinical outcomes in patients with ovarian cancer. Methods:Forty-eight patients with ovarian cancer hospitalized in our hospital between January,2008 and December 2009 were included in the study group,and a contemporary cohort of 30 healthy volunteers of the same age was included in the control group. Enzyme-linked immuno sorbent assay( ELISA)method was used to measure serum HE4 and VEGF levels in the two groups. All ovarian cancer patients underwent surgery according to their disease condition. Then,serum HE4 and VEGF levels were measured for reexamination at 1 d,3 d,5 d,7 d and 10 d after the operation. The reoccurrence rate,disease free survival(DFS),and other clinical outcomes in 5 years were statistically analyzed. The serum HE4 and VEGF levels in patients with different clinical outcomes were compared. ROC curve was used to analyze the prediction value of serum HE4 and VEGF levels on the clinical outcomes in patients with ovarian cancer. Results:Compared with the control group,the preoperative serum HE4 and VEGF levels in the study group were significantly increased(P﹤ 0.05). The serum HE4 and VEGF levels in the study group at 7d and 10d after the operation significantly decreased compared with those before the operation(P﹤0.05). The recurrence rate and mean DFS in the study group was 60.42% and(3.11± 1. 69)years,respectively. The preoperative and postoperative serum HE4 and VEGF levels in patients with DFS shorter than mean level and reoccurrence significantly increased compared with those in patients with no reoccurrence and DFS longer than mean level,and the differences were statistically significant(P﹤0.05). Area under the ROC curve,sensitivity,specificity and accuracy of ovarian cancer recurrence and DFS predicted by serum HE4 and VEGF levels were all higher than those clinical outcomes of ovarian cancer predicted by serum HE4 or serum VEGF level alone.Conclusion:The serum HE4 and VEGF levels in patients with ovarian cancer are high. The accuracy of serum HE4 and VEGF levels in predicting clinical outcomes of ovarian disease is high. Thus,ovarian cancer patients with increased serum HE4 and VEGF levels should be alert to the occurrence of adverse clinical outcomes,with timely intervention and improvement.