The Application Of B2-Micro Globulin And Cystatin Cin The Evaluation Of Early Renal Function Damage Of Patients With Gynecological Malignant Tumo

ObjectiveBy comparing the evaluations’differences between the traditional method and the combination examination of β 2 microglobulin and cystatin C in the gynecologic tumor patients who were treated with chemotherapy based on platinum,we tried to figure out a better way to test the kidney function in their early damages for clinical doctors so that we could protect the kidneys and improve the effects by choosing proper medication.MethodsWe retrospectively analyzed 86 diagnosed gynecologic tumor patients who received platinum based chemotherapy from December 2013 to October 2015 in the First Affiliated Hospital of GuangXi Medical University, meanwhile, there were 43 healthy volunteers included in the control group. They were confirmed diagnosed with or without cancer by their medical history/manifestations/ laboratory tests/CT or MR scanning, the information recorded including: age,surgical history,medical history causes and complications. The five indicators were: β2-MG/Cys-C/Scr/Ccr/BUN, we compared the positive rate separately and jointly and then analyzed with IBM SPSS 21.0Results1 Experimental groupIn the first and second chemotherapy, there were no significant difference in the level of β2-MG、CysC、CCr、BUN、SCr before therapy (P>0.05)。 After the fouth and sixth chemotherapy, there were significantly increased in the level of β2-MG、CysC (P<0.05). Compared with the previous decline,the level of Ccr fell more than 20%. there were no significant difference in the level of BUN、SCr before therapy (P>0.05)2 Correlation analysisAccording to the comprehensive correlation analysis, in the experimental group and the sixth chemotherapy group,β2-MG/CysC and Ccr were negative correlated. There are no correlation between BUN/SCr and Ccr.3 Comparison of indicators in diagnostic efficacy for early kidney damageComparison of indicators in diagnostic efficacy for early kidney damage With sensitivity as y-axis which represent true positive rates and 1-specificity as x-axis which represent false positive rates,we drew the ROC (receiver operating characteristic curve) and analyzed the diagnostic efficacy for kidney damage in these indicators, it showed the AUC of β 2-MG、CysC、Ccr、SCr and BUN were:0.946,0.675,0.582,0.543and0.524 (P< 0.05) in the experimental group, the AUC of β 2-MG、CysC、Ccr、SCr and BUN were: 0.956,0.655,0.545,0.588and 0.585 (P< 0.05) in the sixth chemotherapy group. β 2-MG、CysC indicated higher value for their better sensitivity and specificity.4 The combination test of Cys-C and β 2-MGWith The level of CCr downed>20%, positive rates of this combined test in the experimental group was 41.3% which is higher than the single detection: β2-MG (23.9%)and Cys-C(34.8%), this showed the significant difference(x 12=10.000, x 22=4.689,P<0.05).ConclusionsSerum β2-MG. CysC. Ccr are better in indicating the early kidney damage in those patients with chemotherapy than Scr and BUN because their different sensitivity. Further more,the combination test of β2-MG and CysC showed higher diagnostic value in early kidney damage for those patients. We recommend the combination test of β2-MG and CysC could replace Ccr as the gold standard for early diagnosis of kidney damage in the malignant tumor patients who receive chemotherapy.