The Value Of SCC-Ag、TK1、HE4 In The Diagnosis And Treatment Of Cervical Malignant Tumors

Objective:To investigate the significance of serum squamous cell carcinoma antigen(SCC-Ag),cytoplasmic thymidine kinase 1(TK1)and human epididymal secretory protein 4(HE4)in the diagnosis and treatment of cervical malignant tumors.Methods:From January 2016 to June 2019,80 patients with cervical malignant tumors(cervical malignant tumors group),56 patients with cervical intraepithelial neoplasia(benign cervical diseases control group)and 60 patients with normal physical examination(control group)were selected.In the same period,patients with cervical intraepithelial neoplasia were treated as benign cervical diseases control group,and patients with normal physical examination were treated as normal control group.According to the classification of cervical malignant tumors by FIGO in 2009,there were 68 cases of squamous cell carcinoma and 12 cases of adenocarcinoma.Pathological stage:30 cases of stage Ⅰ-Ⅱ and 50 cases of stage Ⅲ-Ⅳ.Among 56 patients with cervical intraepithelial neoplasia,39 were HSIL and 17 were LSIL.Among the selected samples,the age of patients with cervical malignant tumors was 35-87 years old,with an average age of(59.84+11.82)years old,the age of patients with cervical intraepithelial neoplasia was 22-64 years old,and the average age of patients with cervical intraepithelial neoplasia was(44.66+10.47)years old.The control group was 23-74 years old,with an average age of(44.47+12.44)years old.There was no significant difference in age among groups(P>0.05).The levels of SCC-Ag and HE4 in serum were detected by chemiluminescent fully automatic immunoassay Abbott i2000SR,and the levels of TK1 in serum were measured by thymidine kinase 1 cell cycle analysis kit.SPSS23.0 software was used to process the data,and the significance of each index in the diagnosis and treatment of cervical malignant tumors when used alone or in combination was counted.Result:1.The serum levels of TK1,SCC-Ag and HE4 in three groups were compared.Compared with the serum TK1,scc-ag and HE4 levels in the cervical malignant tumor group,the levels in the benign reference group and the healthy control group were similar,and the difference was not statistically significant(P>0.05,),but all the levels were lower than those in the cervical malignant tumor group.2.Serum levels of TK1,SCC-Ag and HE4 in patients with cervical malignant tumor in different pathological types and TMN stages.The TK1 level was similar among different pathological types of cervical malignant tumor(P>0.05),and the difference was not statistically significant.Serum SCC-Ag level in patients with the cervical adenocarcinoma was significantly lower than that in patients with cervical squamous cell carcinoma(P<0.05),and the difference was statistically significant.However,the HE4 level of cervical adenocarcinoma patients was higher than that of cervical squamous cell carcinoma(P<0.05),and the difference was statistically significant.The levels of TK1,SCC-Ag and HE4 in patients with stage ⅰ-ⅱ cervical cancer were lower than those in patients with stage ⅲ-ⅳ cervical cancer(P<0.05),and the differences were statistically significant.3.Serum levels of TK1,SCC-Ag and HE4 were compared before and after treatment.After treatment,serum TK1 and SCC-Ag levels in patients with cervical cancer were significantly lower than those before treatment(P<0.05),with statistically significant differences.HE4 level was slightly higher than that before treatment(P>0.05),and the difference was not statistically significant.4.The clinical value of serum TK1,SCC-Ag and HE4 in the diagnosis and differential diagnosis of cervical cancer.ROC curve was drawn according to the serum TK1,SCC-Ag and HE4 levels.The results showed that the area under ROC curve independently detected by serum TK1 was 0.766(95%confidence interval 0.698～0.883),the optimal cut-off value was 1.765 PM/L,the specificity was 76.7%,and the sensitivity was 68.8%.The area under ROC curve detected by scc-ag alone was 0.879(95%confidence interval 0.820～0.939),the optimal cut-off value was 1.25 ng/mL,the specificity was 95.7%,and the sensitivity was 78.8%.The area under the ROC curve separately detected by HE4 was 0.767(95%confidence interval 0.698v0.836),the optimal cut-off value was 47.45 pmol/L,the specificity was 78.4%,and the sensitivity was 68.8%.The area under ROC curve detected by TK1 and SCC-Ag was 0.903(95%confidence interval:0.853～0.953),the corresponding specificity was 98.3%,and the corresponding sensitivity was 78.3%.The ROC curve area under the combined detection of TK1 and HE4 was 0.747(95%confidence interval 0.674～0.820),the corresponding specificity was 81.9%,and the corresponding sensitivity was 65.0%.The area under ROC curve detected by SCC-Ag and HE4 was 0.896(95%confidence interval 0.842～0.949),the corresponding specificity was 96.6%,and the corresponding sensitivity was 81.3%.The area under the ROC curve detected by the three combined tests was 0.926(95%confidence interval 0.882～0.970),the corresponding specificity was 96.6%,and the corresponding sensitivity was 81.3%.CONCLUSION:Serum TK1,SCC-Ag and HE4 levels are closely related to the incidence,pathological type and therapeutic effect of cervical malignant tumors.Combined detection is helpful to the diagnosis and evaluation of curative effect of cervical malignant tumors.