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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。
Objective: To investigate the value of serum human epididymal secretory protein 4 (HE4) and vascular endothelial growth factor (VEGF) in predicting the clinical outcome of ovarian cancer. Methods: Forty-eight ovarian cancer patients admitted to our hospital from January 2008 to December 2009 were selected as the observation group and 30 healthy volunteers of the same age were selected as the control group. Serum levels of HE4 and VEGF were detected by ELISA. Ovarian cancer patients were treated according to the condition, and at 1, 3, 5, 7 and 10 d postoperative review of the above items. Statistics of patients within 5 years of recurrence and disease-free survival (DFS) and other clinical outcome of patients with different clinical outcomes of serum HE4 and VEGF levels and ROC curve analysis of ovarian cancer patients serum HE4 and VEGF levels combined prediction The value of clinical outcome. Results: Compared with the control group, the serum levels of HE4 and VEGF in the observation group were significantly increased (P <0.05). Compared with the preoperative level, the levels of HE4 and VEGF in the observation group decreased significantly at 7 and 10 days after operation (P < 0.05). The observation group had a recurrence rate of 60.42% and an average DFS of (3.11 ± 1.69) years. Compared with non-recurrent patients and patients with longer than average DFS, preoperative and postoperative serum levels of HE4 and VEGF were significantly higher in relapsed patients and shorter-term DFS patients (P <0.05). Serum HE4 and VEGF levels combined to predict the area under the ROC curve of recurrence and DFS of ovarian cancer, sensitivity, specificity and accuracy were higher than serum HE4 levels or serum VEGF levels alone prognosis of ovarian cancer clinical outcome. Conclusions: Serum levels of HE4 and VEGF in patients with ovarian cancer are high, and the combination of serum HE4 and VEGF levels is highly accurate in predicting the prognosis of ovarian cancer. Ovarian cancer patients with elevated serum levels of HE4 and VEGF should be alert to their poor clinical outcome The emergence of the situation and timely intervention to improve the clinical outcome of patients with diseases.