The Value Of Sialic Acid In The Diagnosis Of Endometrial And Ovarian Cancer

Objective Determining the expression levels of serum SA(sialic acid),CA125 and HE4(human epididymis protein 4)in patients with endometrial carcinoma,ovarian cancer,uterine benign disease,benign ovarian disease and healthy controls to estimate the value of SA in the diagnosis of endometrial and ovarian cancer.Methods The serum concentrations of SA,CA125 and HE4 in 47 patients with endometrial cancer,30 patients with benign uterine diseases,117 patients with ovarian cancer,83 patients with benign ovarian tumor and 60 healthy controls were determined by using the enzymatic and electrochemiluminescence method.Serum SA,CA125 and HE4 levels were expressed in median and quartiles.Multivariate comparisons were performed using the nonparametric Kruskal-Wallis H test,and comparisons between groups were performed using the Mann-Whitney U test.Estimate the value of sialic acid(SA)in the diagnosis of endometrial and ovarian cancer by comparing with CA125 and HE4.The chi-square test was used to compare the sensitivity and specificity of different indexes.The ROC-AUC of each test index was compared by Z test.SPSS21.0 and medcalc were used for statistical analysis.p <0.05 represents a statistically significant difference.Results(1)There were statistical significant differences in the serum SA,CA125 and HE4 levels among the healthy control group,the uterine benign disease group and the endometrial carcinoma group(H=16.624,9.689,50.256,p < 0.05).Serum SA,CA125 and HE4 levels had statistical differences among the healthy control group,benign ovarian tumor group and ovarian cancer group(H=104.467,142.332,116.023,p < 0.05).(2)The median concentrations of SA and HE4 were significantly higher in patients with early and late stage endometrial cancer than that in healthy(U=764.50,376.50,p < 0.05)and their corresponding benign disease controls(U=470.50,322.0,p < 0.05).The median concentrations of SA,CA125 and HE4 were significantly higher in patients with early and late stage ovarian cancer than that in healthy(U=1067.0,301.0,634.0,p < 0.05)and their corresponding benign disease controls(U=1202.0,1192.5,1300.0,p < 0.05).The serum SA,CA125 and HE4 levels in late stage ovarian cancer group were significantly higher than that in early stage ovarian cancer group(U=1006.5,797.0,884.5,p < 0.05).(3)When the control group was healthy controls,the specificity(81.7%)of SA to diagnosis of endometrial carcinoma was significantly higher than that of CA125(55.0%)(p < 0.05).When the control group was uterine benign disease group,the specificity SA to diagnosis of endometrial carcinoma(80.0%)was significantly higher than that of CA125(30.0%)(p < 0.05).The sensitivity of combination of three biomarkers(100%)was significantly higher than that of SA and HE4(p < 0.05).When the control group was healthy controls,The sensitivity of the combined detection to the diagnosis of ovarian cancer(92.3%)was significantly higher than that of SA and HE4.When the control group was ovarian benign disease group,the sensitivity of SA+CA125+HE4(91.5%)were significantly higher than those of CA125+HE4(83.7%)(p < 0.05).(4)When the control group was healthy controls,the ROC-AUC of SA+CA125+HE4 was significantly higher than those of SA and CA125(Z=3.590,4.386,p < 0.05).The ROC-AUC of SA+CA125+HE4 to diagnosis of endometrial carcinoma was significantly higher than that of SA,CA125,HE4 and CA125+HE4(Z=2.664,3.244,2.041,1.964,p < 0.05)when the uterine benign disease group was the control group.The ROC-AUC of SA+CA125+HE4 was significantly higher than that of SA,CA125,HE4(Z=3.239,2.119,2.684,p < 0.05)when the control group was healthy group and ovarian benign disease group.Conclusion SA has very high sensitivity and specificity for detecting endometrial and ovarian cancer and it is useful in the diagnosis of the two cancers.Combined with CA125 and HE4,SA has a higher diagnostic value for endometrial cancer and ovarian cancer.