文章摘要
官燕飞,陈志强,袁春雷,袁 斌,彭建明,陈 昂.基于外周血循环肿瘤细胞和ROMA指数联合检测在早期卵巢上皮性癌诊断中的初步评价[J].南京医科大学学报,2020,(4):570~574
基于外周血循环肿瘤细胞和ROMA指数联合检测在早期卵巢上皮性癌诊断中的初步评价
Preliminary evaluation of combined detection of peripheral blood circulating tumor cells and ROMA index in the diagnosis of early ovarian epithelial carcinoma
投稿时间:2019-05-17  
DOI:10.7655/NYDXBNS20200419
中文关键词: 循环肿瘤细胞  ROMA指数  卵巢上皮性癌
英文关键词: circulating tumor cell  ROMA index  epithelial ovarian cancer
基金项目:广东省医学科学技术研究基金立项课题(A2019348,B2019124);中山市社会公益科技研究专项立项(2018B1035,2019B1090);中山市卫生健康局医学科研立项(2019J165)
作者单位
官燕飞 南方医科大学附属中山博爱医院检验科广东 中山 528400 
陈志强 南方医科大学附属中山博爱医院病理科广东 中山 528400 
袁春雷 南方医科大学附属中山博爱医院检验科广东 中山 528400 
袁 斌 南方医科大学附属中山博爱医院检验科广东 中山 528400 
彭建明 南方医科大学附属中山博爱医院检验科广东 中山 528400 
陈 昂 南方医科大学附属中山博爱医院病理科广东 中山 528400 
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中文摘要:
      目的:探究外周血循环肿瘤细胞(circulating tumor cell,CTC)联合罗马(ROMA)指数检测在早期卵巢上皮性癌(epithelial ovarian cancer,EOC)诊断中的价值。方法:选取2017年6月—2019年4月期间于中山市博爱医院和中山大学肿瘤防治中心就诊的105例早期EOC患者(恶性组:手术病理分期为ⅠA期和ⅠB期)、152例卵巢上皮性良性肿瘤患者(良性组)和183例女性健康体检者(对照组)为受试者,采集受试者术前静脉血,检测CTC、人附睾蛋白(human epididymal protein,HE4)及糖类抗原125(carbohydrate antigen 125,CA125)水平,结合受试者的绝经状况计算ROMA指数,比较CTC与ROMA指数单项和联合检测结果在3组受试者之间、EOCⅠA期与ⅠB期之间的差异,综合评估CTC、ROMA指数及联合检测诊断早期EOC效能的差异。结果:①CTC、ROMA指数检测结果及单项和联合检测阳性率均在恶性组中最高。②EOC的ⅠB期CTC、ROMA指数检测结果大于ⅠA期,差异具有统计学意义(Z=3.135,P=0.002;t=34.56,P < 0.001)。联合检测阳性率在EOC的ⅠA期和ⅠB期之间差异具有统计学意义(χ2=5.24,P=0.02)。③CTC诊断早期EOC的特异度和符合率最高,但是与联合检测相比差异均无统计学意义;联合检测诊断早期EOC的灵敏度最高,与CTC、ROMA指数单项检测相比差异均具有统计学意义(均P < 0.001);联合检测诊断早期EOC的约登指数最大;联合检测诊断早期EOC的整体综合效能较高,灵敏度、特异度、符合率、约登指数分别为94.29%、84.18%、86.59%、0.785。结论:CTC和ROMA指数单项检测在诊断早期EOC均有一定意义,其检测结果跟ⅠA和ⅠB分期相关。与单项检测相比,联合检测对于诊断早期EOC及分期预测表现出了较高的综合效能,具有较高的临床实用价值。
英文摘要:
      Objective:To explore the value of peripheral blood circulating tumor cells(CTC)combined with ROMA index in the diagnosis of early epithelial ovarian cancer(EOC). Methods:From June,2017 to April,2019,105 patients with early EOC(malignant group:stage ⅠA and stage ⅠB),152 patients with benign ovarian epithelial tumors(benign group)and 183 healthy women(control group)were selected as subjects. Preoperative venous blood samples were collected and the CTC,human epididymal protein(HE4),and carbohydrate antigen 125(CA125)were measured. The ROMA index was calculated according to the menopausal status of the subjects. The differences of single and combined test results of CTC and ROMA index among the three groups and the differences between theⅠA andⅠB stages of EOC were compared. The efficacy differences in early EOC diagnosesby using CTC and ROMA index and their joint detection were comprehensively evaluated. Results:①The values of CTC and ROMA index,and the positive rates of single or combined detection were all the highest in the malignant group. ②The values of CTC and ROMA index in the ⅠB stage of EOC were higher than those in the ⅠA stage(Z=3.135,P=0.002;t=34.56,P < 0.001). The difference in the positive rate of combined detection between the ⅠA and ⅠB stages of EOC was statistically significant(χ2=5.24,P=0.02). ③The specificity and coincidence rate of CTC for early EOC were the highest,but there was no significant difference from those of combined CTC and ROMA detection(P > 0.05). The combined detection shows the highest sensitivity in the diagnosis of early EOC,and its differences from the single detection of CTC and ROMA index has statistical significance(P < 0.001). The Youden index of early EOC was the highest by combined detection. The sensitivity,specificity,coincidence rate and Youden index of combined detection are 94.29%,84.18%,86.59%,and 0.785,respectively,showing a relatively high overall efficacy in the diagnosis of early EOC. Conclusion:Single detection of CTC and ROMA index has some significance in the diagnosis of early EOC and the results are correlated with ⅠA and ⅠB staging. Compared with the single detection,combined detection shows a higher comprehensive efficacy in the diagnosis of early EOC and for staging prediction,and thus is of a higher clinical value.
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