| BackgroundEndometrial carcinoma is a common malignant tumor in female genital system.The incidence of gynecologic malignancies in the world accounted for second.The incidence of endometrial cancer in China has a significant upward trend,which seriously affects women's physical and mental health.the 5 year survival rate is only 30%~40% of the advanced patient.In recent years,with the widely used clinical surgical treatment,the five-year survival rate is significantly increased,but the recurrence rate is still high.Therefore,The diagnosis and monitoring of endometrial cancer is particularly important.Nowadays,tumor markers have been widely used in clinical practice,But the tumor marker detection specificity and sensitivity were unable to achieve the expected.Therefore,it is still the focus of the current study to find effective methods to screen and monitor endometrial cancer so that more patients can get early diagnosis and treatment.At present,the joint detection of multiple tumor markers is more and more popular in clinical doctors.ObjectivesTo investigate the level of carbohydrate antigen CA125(Carbohydrate antigen125),CA199(Carbohydrate antigen199)and osteopontin(OPN)in endometrial carcinoma with different pathological staging,the level before and after operation,and to evaluate the value of combined detection in the diagnosis and treatment of endometrial cancer,and the value of disease detection.Methods1.According to the inclusion criteria,to select 32 cases of endometrial cancer diagnosed by pathological examination as the observation group,in the Department of Gynecology of our hospital from December 2013 to December 2014.32 cases of endometrial benign lesions diagnosed by postoperative pathological examination(endometrial benign lesion group),Another collection of the same period by the physical examination center of our hospital qualified health women 32 cases as the healthy group,the serum levels of CAl25 and CA199 were measured by electrochemical immunoassay.while the level of OPN was measured by enzyme-linked immunosorbent assay.To compare and analysis the expression level in three groups before operation expression level and positive expression rate,and the expression level in different surgical pathologic staging.to compare preoperative and postoperative expression level and endometrial cancer group after follow-up in patients with recurrent expression level.2.Take the pathological diagnosis as the golden standard,To compare sensitivity,specificity,Positive predictive value,negative predictive value and specific volume of three indicators alone detection and combined detection in endometrial carcinoma.3.All data used in this clinical study were analyzed using SPSS19.0.Results1.The expression levels of CA125,CA199 and OPN in the endometrial cancer group were higher than those in the endometrial benign disease group and the healthy group(P < 0.05).The difference was statistically significant,While the levels of serum CA125,CA199 and OPN in patients with endometrial benign lesions were not statistically significant compared with the healthy group(P > 0.05).2.The positive rate of uterine endometrial carcinoma group of CA125,CA199,OPN single detection were significantly higher than those of the endometrial benign lesion group and the healthy control group,the difference has statistical significance.Endometrial carcinoma group,the positive rate of single detection from high to low as follows:(50.00%),CA125 and CA199(43.75%),OPN(46.88%).The positive rate of combined detection was 81.25%,significantly higher than that of single detection(?~2 respectively 6.926,960,8.212,P < 0.05)3.Diagnosis of serum CA199,CA125,OPN three indexes detection alone and combined detection sensitivity of endometrial cancer were 50.00% and 43.75%,46.88%,81.25% and specificity were 79.69%,81.25% and 85.94%,73.44%,the positive predictive value were: 55.17% and 53.85%,62.50% and 61.90% and negative predictive value were 76.12%,74.29%,76.39% and 88.68%,than the number of points don't 3.92,337,5.92,11.99.4.In the endometrial cancer group,With the increases of surgical pathological stage,severe(?~?)in serum of patients CA125,CA199,OPN average was significantly higher than that of mild(grade ?~ ?)patients,the difference was statistically significant(P < 0.05).5.Endometrial cancer group before and after the operation of three indicators are significantly different(P <0.05),and endometrial benign lesions before and after operation,two indicators showed no significant difference(P >0.05).6.The serum levels of CA125,CA199 and OPN were significantly higher in the patients with recurrent endometrial cancer after surgery than that in one month after surgery,and the difference was statistically significant(P < 0.05).Conclusion1.The combination of the CA125?CA199 and OPN is an effective method to detect Endometrial carcinoma,and it can improve the diagnosis efficiency for ovarian carcinoma.2.Combined detection of serum CA125,CA199 and OPN can reflect the severity of the disease to a certain extent,and can be an important reference index for monitoring the occurrence and development and evaluating the prognosis of the patients. |
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